Laserfiche WebLink
GROUNDWATER PURGE AND SAMPLE FORM (Cont.) Date / <br /> PROJECT NAME__/ 7_2yZ WELL NUMBER: <br /> PROJECT NUMBERA�y& PERSONNEL <br /> SAMPLE DATA: <br /> TIME SAMPLED _ <br /> DEPTH SAMPLED (ft) <br /> SAMPLING EQUIPMENT _7_z.t1-'AFw ZSscjlry - - -- <br /> COMMENTS <br /> SAMPLE NO.of CONTAINER FIF1 D VOLUNNE SHIPPED UNDER ANALYSIS <br /> NO_ CONTAINERS TYPE PRESERVATIVE FILTRATION ALLfO 1URHIUITY COLOR CIWNOFCUSTOOY REWFST COMIAEHiS <br /> {mI ar q AT 1'C(YM) (METHOD) <br /> 15py <br /> ►,moi y 5 r� <br /> PURGE WATER DISPOSAL NOTES: <br /> TOTAL DISCHARGE (gal)�, r _ <br /> DISPOSAL METHOD <br /> DRUM DESIGNATION(S)/VOLUME Zw <br /> COMMENTS <br /> WELL HEAD CONDITIONS CHECKLIST(Circle YES or NO--if NO, add comments) <br /> WELL SECURITY DEVICES OK (BOLLARDS, CHRISTYLI ASING LID AND LOCK)4� NO <br /> INSIDE OF WELL HEAD AND OUTER CASING DRY? NO <br /> WELL CASING OK' NO <br /> COMMENTS A� <br /> GENERAL <br /> WEATHER CONDITIONS <br /> TEMPERATURE (specify OC/OF) <br /> PROBLEMS ENCOUNTERED DURING PURGING OR SAMPLING 42 <br /> COMMENTS <br /> c c Project Manager <br /> .lob File <br /> Other <br />