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• <br />Address: <br />Well ID: <br />Collected By: <br />Total Depth (feet): <br />Screen Length (feet): <br />Casing Diameter (inches): <br />• <br />DOMESTIC/MUNICIPAL PROGRAM <br />WELL SAMPLING DATA SHEET <br />2J,'%2 '.k1lrlYly R00M:i Date: <br />Purge Start Time: <br />Purge End Time: <br />V -.o J vi <br />1044 <br />1 oSS <br />Sampling Time: It 00 <br />Purge Sample Rate: <br />Total Purge Volume (E <br />Gallons Purged <br />pH <br />Conductivity <br />(us/cm) <br />Temperature <br />('C) <br />Other <br />Comments: watl kc CA::,,*CA=k tY1 �Oo�G�G-yo�r"C�. N�oYY1� ow�rlGrS <br />sael�ed +KCt-V we- sc.mPle Fv-On-v 0c <br />hov�c b`1 Fror�cidoor. <br />Field Certification: <br />Signed Date <br />