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�1eJ` <br /> SAINWLTNG INFORMATION SHEET //��l� <br /> >;nvirotrme�t <br /> asultants,Jnc. <br /> Sample IDylc <br /> # i .J -Z Project Name. R��I' _ Project No <br /> F t'�Omaon (address) <br /> )late Spied: —0—� 1-une <br /> I-WON"Lssembly condition- Good Farr Poor(If poor, see. comments) <br /> EquipFwnt Replaced: bolts locks locking cap <br /> e Wef1$epth 633 ft beloIi, w top of casing Casing diameter inches <br /> . pqptff tq water(below top of casing) �-- ft; Date: <br /> #Ni IYCasing Volume Multiplier: 0.16 for 2", 4 65 faor 4% 1.47 for 6" <br /> E °Punting method: Submersible pump Bailer Centrifugal pump Other <br /> At least well volumes have been evacuated before sampling. <br /> Tubing (type, - (new or previously used) was used to purge well <br /> Sampling method- Disposable bailer Sampling par <br /> Samples collected Sample appearance --- <br /> Note any sampling problems -- <br /> GROUND WATER EVACUATION/STABILIZATION DATA <br /> Cumulative Volume of <br /> r. Conductance Water Leve! Water Removed fmM Well <br /> Ttmc r Temperature ('F) pH Units (umnos/cm) (Nearest 0.01 ft) (gallons) <br /> 30 <br /> Comments. <br /> i <br /> T�sp�fton(thermal preservation) <br /> Form completed br Sampled by <br />