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Birch technical 6enices GROUNDWA i LR SAMPLING FORM <br /> 116 Liberty Street <br /> Santa Cruz.G 95060 Well Number- mw - -S <br /> (408)459-0718 •- <br /> Pro ect Number: fit! 1 Sample Type. roundwater OTnp Blank ODuplicate of <br /> Sl6n Number: D ` o is <br /> Dater I / ti� Sampled by: �V s <br /> WELL IPIli RGING <br /> PURGE Casing Diameter (inches) O 2" 43" 04" 04 5" 06" 0 <br /> VOLUME Volume Factors: 0 1632 0 3672 0 6528 0 826 1469 <br /> Total Depth of Well Initial Water Level. PURGE METHOD: <br /> O Honda Pump <br /> Total Volume Purged: Time Elapsed: ODisposable PolyTubtng( ft) <br /> OSpeed Winch <br /> Calculated Purge Volume: ODisposable PVC Bailer(sX--j <br /> OOther <br /> - — x = x a (gallons) <br /> Total Depth Water Level Well Vol Fac #of vol to Purge Calculated Purge Volume <br /> COMMENTS: <br /> y� 11 _ 'ef�4 Subjective Analyi „Prior to Purging <br /> SHEEN Depth to Product Product Thickness <br /> OYes ONo (ft} (ft} <br /> P Lt"x,+ � SAMPLING METHOD <br /> OPVC Disposable Bailer Time Sampled <br /> Po P <br /> OTeflon Bailer (24 bour clock) <br /> OOther <br /> WELL SAMPLING PARAMETERS <br /> Gallons Temp Cond Analysis No Conm= <br /> Removed Time pH of (umhos/cm) Required of Type preservatives <br /> EPA 601 VOA's <br /> TPH-G/BTEX 3 VOA's HCl <br /> TPH- Diesel Amber <br /> Liter <br /> TOG 5520 BF Amber "2SG4 <br /> Liter <br />