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IM' WELL SAMPLE FIELD LOG <br /> Date: � 1 .9 LOc, Well No: (-0 W - y <br /> Jab Name: a-kk-,' 1 Job No: �C� l 3 -01 Technician: C�„`r� -V,J Weather: <br /> 1 Well Casing Diameter: []2" Z4" []fi" other: <br /> Weil Head Protection: 2 OK ❑Needs Following Repairs: <br />' DTGW 1Ljq Total Well Depth 7'-1 'Z`t Free Product Thickness — Well Under Pressure Yes z No <br /> Discoloration: (3p-,,J Odor: f1,���•f- _ Sediments in Well Water E]Yes 2No <br />' Well Purge Equipment I Z W Pure Volume (gal): �O <br /> Purge Water Disposition :52>Lel ler-1 ,�1 ',+ , Well Dewatered [DYes ZNo <br /> 1 <br /> Time I Volume al Tem (°C) Cond. (Ws/cm) H ORP (MA- <br /> 1000 <br /> my 00c (s. 9 Cc67 (fib <br /> . is to - 1--�•9 -7-00 & .,( i <br /> 1 Water Sample Equipment:Pv1E5,SV1 _ CA 9% /y4bFA-- Sample Time: <br /> Sample Containers: 71 Liter Amber Placed on Ice: ©Yes No <br /> Z250 ml Chain of Custody: 0 Yes n No <br />' ❑Unpreserved VOA's Laboratory: O KI FF [Z TEG <br /> Z Preserved VOA's ❑Other: <br /> F] Plastic <br /> Comments: <br /> Technician Signature: <br /> 1 <br />' Rev:318/00 TM <br />