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WELL DEVELOPMENT/SAMPLING DOCUMENTATION FORM <br /> Project Name: Job # J' g�7` Well# <br /> Dates: Samples 1D: �l <br /> ling Team: fLa <br /> Purpose of Sampling: 0 Initial X Quarterly ❑ Verification Other: <br /> Weather Conditions: dart _ <br /> GROUNDWATER LEVEL/CASING VOLUME <br /> Conversion Casing <br /> Description Time Depth Total Depth Feet of Water Factor Volume <br /> OC to GW ft. toals. (gallons) <br /> Initial (o 57- —74-a-V 3• ?(o • l� f ' <br /> After development/ <br /> Pur in C� S,�Ct <br /> At Time of Three Casing Volumes 7'�_.Gals. <br /> Sam lin l Ll�� Ten Casing Volumes Gals <br /> WELL DEVELOPMENT/PURGING <br /> Equipment: ZSubmerisible Pump ❑ Bailer Cl Sandpiper Other: <br /> Method: 9 ,, Ita.'-7 <br /> Description <br /> Decontamination Method: <br /> Description <br /> Water Containment: Drums © Baker Tank © Treatment System ❑ Other: <br /> l�led: -e,, <br /> Start Time Volume Water Temperature EC pH Observation <br /> Extracted OF/OC mV Color,Turbltity,Oils,Odor <br /> r cx-� l-1, D. .cD : S <br /> SAMPLE INFORMATION . <br /> Lab: <br /> pw- <br /> Sampling Containers/No. of Containers Preservation <br /> ❑ 1 Liter Amber ❑ Ice Cl Other <br /> 15-40 ml VOA ❑ Ice ❑ Other <br /> ❑ Other © Ice ❑ Other <br /> Device: Z Bailer, Disposable ❑ Other <br /> Pertinent Observations, <br /> Deviations From Standard Sampling Protocol: <br /> GHH ENGINEERING INC. <br /> 11960 Heritage Oak Place, Suite 28,Aurum, CA. 95603 (530) 886.3100 <br />