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Delta <br /> ` SAJmpL]NG INFORMAnON SHEETA Can <br /> �vrron��t <br /> suttants,inc. <br /> Sample ID!! ref 6J—`7- Project Name. �/��' project NO% �.5,ar <br /> " ocaaon (address) - <br /> bate SMpled: � /�_ ! [�J Trine <br /> `whew assembly condition: Good Fair Poor(1f poor, see comments) <br /> EquiApent Replaced: bolts locks locking cap <br /> WeR-be pth ft below top of casng Casing diameter inches <br /> J?q9dF oq water(below top of casing) SZ' �- ft. Date: 1 / Time <br /> 'Ve1FC2stn9 Volume Multiplier: 0.16 for 2% 0.65 for 4", 1.47 for 6" <br /> t `P'utktitg method: Submersible pump Bader Centnfugai 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 port <br /> Samples collected Sample appearance <br /> Note any sampling problems <br /> GROUND WATER EVACUATION/STABILIZAXIOI*t DATA <br /> ' � Crrmuianve Volume of <br /> "" Conductance Water Level Water Removed from Well <br /> Time 4 Temperature pH Units (umnos/cm) (Nearest 0.01 R <br /> (gallons) <br /> 20 -L. Q g�7 <br /> 4 ' <br /> Conments: <br /> t <br /> r <br /> Tr4uspvctation(thermal, preservation) <br /> Form completed by: _ Sampled by: <br />