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B1AEf oeSul relnlv,�gci„crn lnc GROUNDWATER SAMPLING FORM <br /> 7.0�El;Enrll rli 12 J7S <br /> 602)72 An0on', 8x01� Well No <br /> (G02)7�0707 <br /> Site 1D <br /> Well F'1MOr)it 0 Remedial-VE AS <br /> Well PV El $t Steel El Other <br /> Project No Z 7oq sb o z Date -( _a Time <br /> /3 Z, <br /> IRecorded G cFN T.& Sampled By <br /> WELL PURGING <br /> Purge Volume Purge Date ?o / Purge Method <br /> CaSing Diameter(D)in <br /> ❑ Bailer-Type <br /> 14 2-inch ❑ 4-inch ❑ 6-inch ❑ Other ] Submersible ❑ Whale <br /> Total Depth of Cosing(rD In feet ❑ Other <br /> I Water Level Depth(WL In feet STOC) <br /> Number of Well Volumes(if Vols)to be Pump Intake Setting <br /> 3 ❑4 ❑5 ClOther ❑ Near BottomXNear Top ❑ Other <br /> I Depth In feet <br /> rrPurge Volume Screen Interval h Feet(STOC) <br /> to <br /> `l Tn I wr X X X 0 0409 00 gallons D(Inches) #Vols Calculated Purge <br /> Pump TimePurge Rate Actual Purge Volume <br /> Start �lfS Stop !2(45'Tirne ElapseB Initial Qpm �/� gallons <br /> Field Parameter Measurements Final gam <br /> Time Time Lapsed Gallons co Conal <br /> Purged (u as/cm) (um s/cm) Temp pH Notes <br /> ko-pt 036 p. a <br /> i <br /> Observations During Purging(well Condition Turbidity Color Odor <br /> Purge Water <br /> Drum(s) El Storm Sewer ❑ Sanitary Sewer <br /> Other <br /> EWELL SAMPLING <br /> Sampling Date ~Z f-b/ Sampling Time 3 OS <br /> Sampling Method Water Level Before Sompling(in feet 8TOC) ,'Zs <br /> Boller-Type ❑ Some as Above <br /> ubmersble ❑ Whale ❑ Grab-Type <br /> El Other ❑ Other-Type <br /> Sampling Distrlbutlon Sample Series <br /> Sample No Containers Vol 4 Analysis Preservative Lab Comments <br /> C �o a <br /> Other Notes <br />