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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 />17J <br />DOMESTIC/MUNICIPAL PROGRAM <br />WELL SAMPLING DATA SHEET <br />.'7J�P� "h�r►►�� Date: <br />(� Purge Start Time: <br />rT t Purge End Time: <br />Sampling Time: <br />Purge Sample Rate <br />4/�Lv/r -1 <br />L5:40 <br />15"'55 <br />tk:ZO <br />14 qAA <br />Total Purge Volume (@ � 0 - <br />Gallons Purged <br />pH <br />Conductivity <br />(us/cm) <br />Temperature <br />('C) <br />Other <br />Comments: <br />Field Certification: <br />Signed Date <br />