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I / <br /> / Parkl <br /> Leaving A Clem Environment <br /> WELL DEVELOPMENT/SAMPLING DOCUMENTATION FORM r <br /> Protect Names � �7 <br /> Job# <br /> Date ' <br /> Sampling ear <br /> (Names/Responsibilities) ' <br /> Purpose of Sampling Initial Quarterly Verfication <br /> Weather Conditions Other <br /> GROUNDWATER LEVEL/CASING VOLUME <br /> De th Total Feet of Conversion ' <br /> j---TTOC to GW Casino Volume <br /> De h Water Factor Gallons <br /> I <br /> nitial <br /> After <br /> At time of Sampling I(o2 ' <br /> Three Casing Volumes Gals <br /> Ten Casing Volumes Gals <br /> WELL DEVELOPMENTIPURGING ' <br /> Equipment Swab-Aire Sub Pu ailer Sandpiper Other <br /> Method Descnptran ^ « ` � <br /> Decontamination Method C2� umts <br /> Water Contamme t ker tank <br /> Labeled t other ' <br /> I t <br /> M 7 <br /> Pum Vol Water T <br /> Time Rate Extracted FI umhas Observations <br /> Start <br /> IN1 --7U- color,turbidi oils odor ' <br /> �9 U <br /> LabSAMPLE INFORMATION <br /> Z4Jcd <br /> Sampling Containers/Number of Containers/Analysis Preservation Description <br /> 1 Liter Amber <br /> 40 ml Voa rt Ice and <br /> t Other Ice and <br /> Time <br /> Ice and <br /> 'Device Dls_p lbs lbs eao Bailer <br /> Pertinent Field Observations Other <br /> Deviations from Standard Sampling Protocol <br />