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WELL DEVELOPMENT/SAMPLING DOCUMENTATION FORM <br /> Project Name:_ A" /Q-f� Job# Well# ✓ <br /> Dates: 5 Samples ID: <br /> 0pling Team: 177 e .) <br /> ose of Sampling: ❑ Initial quarterly ❑ Verification Other: <br /> Weather Conditions: 620- n .A-w' <br /> GROUNDWATER LEVEL/CASING VOLUME <br /> Conversion Casing <br /> Description Time Depth Total Depth Feet of Water Factor Volume <br /> TOC to GW ft. togals.) (gallons) <br /> Initial O -`f 8 (.0 .O 0- d -7 -5;Q1 d <br /> After development) <br /> Purging ; 3�( <br /> At Time of Three Casing Volumes -5 Gals <br /> Sampling 1 Ten Casing Volumes Gals <br /> WELL DEVELOPMENT/PURGING <br /> Equipment. fiCSubmerisible Pump ❑ Bailer ❑ Sandpiper Other: <br /> Method: af=dil -- o <br /> Description <br /> Decontamination Method: <br /> Description <br /> Water Containment: �?LDrums ❑ Baker Tank ❑ Treatment System 0 Other: <br /> L led: <br /> Start Time Volume Water Temperature EC pH Observation <br /> Extracted 7100. mV Color, Turbitity,Oils, Odor <br /> S X02 prr1.�..)r f C j O..� <br /> SAMPLE INFORMATION <br /> Lab: <br /> Sampling Containers/No. of Containers Preservation <br /> ❑ 1 Liter Amber 4 ❑ Ice ❑ Other <br /> X_40 mi VOA_ In (� ___ ❑ Ice ❑ Other <br /> C, Other ❑, Ice ❑ Other <br /> Device: Bailer, Disposable ❑ Other <br /> Pertinent Observations: <br /> Cw'ons From Standard Sampling Protocol: <br /> GHH ENGINEERING INC. <br /> 11960 Heritage Oak Place,Suite 213,Auburn, CA. 95603 (530) 886-3100 <br />