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WELL SAMPLE FIELD LOG <br /> 1 <br />' Date: 17--Z (3 /OC) Well No: (11 LA Z_— <br /> Job Name:.�1��� !c - Job No: <br />'j Technician: � -i,��,��� sa 5� z_ „ Weather: <br />' Well Casing Diameter: 02" Z4" F-]6" other: <br /> Well Head Protection: ZOK 7Needs Following Repairs: <br />' DTGW 10 c"', Total Well Depth "20 oll Free Product Thickness - --Well Under Pressure E]Yes ©No <br /> Discoloration: _L\1Cn7E_ _ Odor: G-n5 Sediments in Well Water []Yes No <br />' Well Purge Equipment: t'Zx/'p c P.' Purge Volume (gal): '�>o <br /> Purge Water Disposition 5•S Ci 1/0,-j z: ,z., Well Dewatered Yes Z No <br /> 1 <br />' Time I Volume al Tem (`C) Cond. s/cm H ORP my <br /> ?Z z5, O 174.0 ccs <br /> + Z . 0 <br /> 1 Water Sample Equipment: e '�CI� l• i�r,t t�,'EI� a� _c_ Sample Time: C��7 <br />' Sample Containers: ❑1 Liter Amber Placed on Ice: Z Yes ❑No <br /> 0250 ml Chain of Custody. [/]Yes F_jNo <br /> ❑Unpreserved reserved VOAO's s Laboratory: �KIFF TEG <br /> P <br /> [�Other: <br /> Plastic <br /> Comments: <br />' Technician Signature: <br /> Rev:318100 TM <br />