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Puree Loa Form <br /> 4Rolc:t Name C S Project Number Q - _76g cite Location <br /> WeII No 1 ,3 Date 03/3 q b. Field Tech Ar <br /> Total Depth s`� Depth tc water 3 S 9 3 Water Colurin Lengut, <br /> Casing Diameter- 7" Casing Factor i_' Volume Calculauon 3_ q <br /> Total Purs Vol=c / a Q) Casing volumes Fr:duced 3- Par:io Type <br /> PSI Meter Calibrated Y or N Cond Mcle• Calibrated cr N <br /> Temp Meter Turnid,r, Nfeter A"' Caiiprted Y or N <br /> [Cz<.ng Factor 2"= 17 3"=38 4'= 66 5'=I 02 6"=i 5 8"=2 6 (In Gallons pc-Ii;:.ter foot)] <br /> T,mc -Prod Rate Gallcrsttotal) DT W Ph Ec Te--;o C,C) 7uroIia:iv Cern.:re;t5 <br /> 3S- 31 0­9- I j39;F i j 1. I AA I <br /> 157ys I I Sutjy36 .s311391 1 3l v' -Pill - � <br /> I l9gs11 21, 1Ip , o <br /> saw I <br /> I f 1 I I I I <br /> I I I I i r 1 I <br /> Stcrzge or Disposal hi_thod Toil Drum; Onsite <br /> Parc.-it Re.tiarge Pnoz;to Sampling Jt)0 Sa-rplc Collection Nicthed____� YV�-�►'� (, <br /> Sample Labeled 3' W <br /> Sainplc Time f�o S' Labor-_tar;, <br /> No of Containe-s <br /> Duplicate TM; Blank Rinsate Blank <br /> Comments G/ <br /> I <br />