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Farmington Water Quality Sampling Form <br /> Groundwater Recharge Program <br /> Location Well ID <br /> Project Number 1511166. Testing Phase Background Extraction Post Extraction <br /> Recorded By Sampled by Date <br /> WELL PURGING <br /> PURGE VOLUME PURGE METHOD <br /> Well casing diameter ❑ Bailer-Type <br /> ❑ 2-inch(.17) ❑ 4-inch(.66) = other El Pump-Type <br /> Well Total Depth(TD,ft.below TOC) El Other <br /> Depth to Water(WL,ft.below TOC) PUMP INTAKE <br /> Depth to free phase hydrocarbons(FP,ft.below TOC) Near topDepth(ft) <br /> Number of casing volumes to be purged Near Bottom Depth(ft) <br /> F]3 � 5 =Other Other <br /> PURGE VOLUME CALCULATION <br /> x x - als <br /> Water Column Length Multiplier No.Vols CALCULATED PURGE VOLUME <br /> Total Purge Time Purge Rate(gpm) gals <br /> Recharge Rate(gpm) ACTUAL PURGE VOLUME <br /> GROUNDWATER PARAMETER MEASUREMENTS Meter Type <br /> Time/Gallons pH Cond. Turbidity ORP Temp deg C DO Depth SAL TDS Color/Odor <br /> Start @ ( ) (NTU) (mV) deg F (mg/L) feet (g/L) Remarks <br /> I <br /> Comments during well purge <br /> Purge water storage/disposal Stomtwater System Other <br /> WELL SAMPLING <br /> SAMPLING METHOD Date/Time Sampled / <br /> Bailer-Type ❑ Dedicated/Disposable Sample port Other <br /> GROUNDWATER SAMPLE PARAMETER MEASUREMENTS Meter Type <br /> Date/Time/%Recharge pH Cond. Turbidity ORP Temp deg C DO DepthSAL TDS Color/Odor <br /> ( ) (NTU) (mV) deg F mg/L) feet % (g/L) Remarks <br /> I <br /> SAMPLING PROGRAM <br /> Sample No lContainer#Nolume lAnalysis iPreservatives IlLaboratory Icomments <br /> QUALITY CONTROL SAMPLES <br /> Duplicate Samples Blank Samples <br /> Original Sample No. Duplicate Sample No. Type Sample No. <br /> Tnp <br /> Rinsate <br /> Transfer <br /> Other. <br /> © <br />