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' EK- <br /> - Well/Piezo ID <br /> Ground Water Sample Collection Record <br />' Client <br /> Date �y <br /> Protect No `7 Y Q .2`1 -/ ; Time Start am/pm <br />' Site Location Finish am/pm <br /> Weather Conds ColleEtor(s) <br />' WATER LEVEL DATA (measured from Top of Casing) p Well Piezometer ❑ <br /> a Total Well Length �c�� c CasingMaterial fi "' e Length of Water Column (a-b) <br /> b Water Table Depth d Casing Diameterf Calculated Well Volume(see back) { <br /> IWELL PURGING DATA <br /> a Purge Method -r <br />' b Acceptance Criteria defined(from workplan) <br /> -Minimum Required Purge Volume(@ I well volumes) <br /> -Maximum Allowable Turbidity NTUs <br />' -Stabilization of parameters % <br /> c Field Testing Equipment Used Make Model Serial Number <br /> - r- � 3 <br /> d Field Testing Equipment Calibration Documentation Found in Field Notebook# Page# <br /> Volume Sec on <br /> Time Removed al T° C!F H (umhos) Turbidity(NTUs) DO Color Odor Other <br /> 4 e -e <br /> W9 7q VA% <br /> f� 6 /en L <br /> - <br /> e Acceptance criteria pass/fail Yes No N/A <br /> Has required volume been removed ❑ ❑ <br /> Has required turbidity been reached ❑ ❑ ❑ <br /> Have parameters stabilized ❑ ❑ ❑ <br />' If no or N/A-Explain below <br /> SAMPLE COLLECTION Method <br /> iSample ID Container Type No of Containers Preservation Analysis Time <br /> r <br /> 1 �- -a <br /> /h! <br /> 122 <br /> 1 Comments <br /> Signature Date <br /> I <br />