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• <br />0 <br />Address: <br />Well ID: <br />Collected By: <br />Total Depth (feet): <br />Screen Length (feet): <br />Casing Diameter (inches): <br />DOMESTIC/MUNICIPAL PROGRAM <br />WELL SAMPLING DATA SHEET <br />2A l)2 hrL'L`- Q 1 Date: <br />_. Purge Start Time: <br />Purge End Time: <br />Sampling Time: <br />Purge Sample Rate <br />Total Purge Volume (E <br />pH <br />Conductivity <br />(us/cm) <br />Temperature <br />('C) <br />other <br />Gallons Purged <br />,Qa <br />.(iL{ <br />-J-s.$r <br />Comments: owv%tr C[4 4 R 0 4. W G`'L � °�'+' tA� f µh �! <br />`'d�� A- tri i y a,44 k,s +ry-s /� Z -3 Hr% prib oe fi v ar' aerrj'�-C, <br />GRG<'b / J - 0 W r\( -P <br />w' l o T r 4q ? <br />i ' <br />Field Certification: _ _ _ `,,/2. 3 <br />Signed Date <br />