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Site Address (a�� r� S Site Number <br /> '+ City - Protect No � <br /> a Sampled By 0-alt-L Protect PM <br /> Date Sampled IZ 1J.2--3L 1-4f <br /> Site Contact Phone No <br /> Water Level Data Purge Volume Calculations Well Purge Method Sample Record Field <br /> Total Casing Three Actual DTW Data <br /> Depth to Top of Depth of Water Well Multiplier Casing Water At Dissolved <br /> water Screen Well Column Diameter Value Volumes Purged No Sample Sample Sample Oxygen <br /> Well ID Time feet feet feet (A) (inches) (B (gallons) (gallons) Purge Bailer Pump Other Time I D Time {mg/L) <br /> sy y,g A4 - I V U/0 d(s[ <br /> yw�z Z 3"`1 5$ •y J4 Vv"L os)*"z- <br /> Vrr�-• D 5 �[ �!'� -SL �t•`t=- �' �9� V•x0 Yw� n -Z <br /> �` d'1 5K• l a :Zts D '( 5U3 Yw pit Ov6q . <br /> Y7 o(Ay -)q,5( N-747 .11 <br /> 07 2-' $z•Gb <br /> rvdx 17,710 151%( •zy .Cpq H <br /> rw 15 C16 Iq A. 71,,V <br /> VW17 39 /07- <br /> 07411 log Gf <br /> Vrrl4' d lay 1?; $S W ti <br /> w g 79' <br /> (A)Casing water Column Multiplier Values <br /> Depth wtr Depth to Bottom 2"=0 5 4"=2 0 6"W4 4 Page 1 of 2 <br />