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Site Ilddress1 �� _ Situ Number: <br /> _ <br /> Project No.: <br /> r ProJact VM: <br /> :3$10 ContacR Ptivne Number: silo..somlt(ec!Dy, NIi'C onto sa1r11led:" ~ <br /> Matey LeM I)a(a _ F'urt e VOIut119 Calcuiatlons Sarrlplinc flttal les Sample RecorT I <br /> Tglavf i"olai Casing- —~� Three ActualOther <br /> 00p1h 16 Screen Depth of Check If Water Wel( Ivlulliplier Casing Wafer D"I'EX 'I'Igl[-g Ml'13L`- ___4_ Dissolved Sample <br /> watev inlefval Weil P(srsr}e Nut Column l7[altteter Value VajOles Purged (6020) (001.5m) (17020) _- Oxygen Frecimicy Sartt(rio Srslnpie <br /> Wel!10 Time (feel] (Boat} (ft�eq RegU11*1 (A) (Indies) (a) (gallons) {gallons} VOA VOA VOA (moot.) (A,S,Q) <br /> FEZI.p. i"Into <br /> ❑ -� ��. ��.�.� � U - a T U T 0 Y � �$! lnw 4 (�Z.� <br /> ❑ ❑ ritt� w� <br /> b5Y �14F ❑_ 31,E ❑ <br /> Ll <br /> CI ❑ ❑ L1 17J <br /> 12 3v�7�. 4 i CJ ❑ 1_.1 ❑ z v 7�'� <br /> ❑ ❑ ❑ <br /> 2�3�•x -- <br /> LJ - AI <br /> 0 CI (:J ❑ <br /> ❑ ------ ❑ _ ❑ <br /> ❑ ❑ fJ -_ -- <br /> ' ❑ ❑ 0 <br /> ___ __ _ _ ❑ --- 1J CJ CJ C <br /> (A)-c.shig taller Crrhrmm QciplS1 lu UVIivolt-Deplh to Water (1j)-mulllptler values: (2"We11:0.8) (A"Well:2.01 (G"Weil'.!IA) Z Sampflrtg Saclueltce: ftlltt�et <br /> Qaarte,ly: <br /> SartlpltnN Notes: List clep..lh of Sort ple of C.O.C.Jim,MW-'1(3U)I. tN0)cu Sura to N(tte II C,O.C.'Provide Lowest Ilei orMq)Litrrd Ayi)i101;)e." Orir 4110)Copies of FL.eSara�Ii n�Slreels are Loci<leel i1r I'sajvct l=ife <br /> If the W;a1er level is below tile lop of the Scruzsl,lake a grab sample ami attack box for NO nURIOC(Ni'). tf Ilse walor level Is move thu sct0en,purJo as nvrrllal, <br /> (LA 134at11t Samptlrlg Slw-II (Page's of 2) Last Printed: 1/12104 <br />