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r",v <br /> ` SAWLING INFORMATION SHEET Defta <br /> A*////Ak Consultants,Inc, <br /> Sample ID#- L?4LJ--9 ` Project Name. Project No <br /> F +'�acation (address) ,, <br /> r �bam Sampled: � !-�� I C)5 Tune: <br /> I 4 <br /> i <br /> W41he4ktissembly condition- Good Fair Poor(If poor, see comments) <br /> dent Replaced: bolts locks locking cap <br /> below GD <br /> Weflbe tt; ,G <br /> f i( Y ` P -- 1 p q C3S1IIg CaSIII�F diameter inches <br /> ptff tq water(below top of casing) S (f ft- Date. ! I Time <br /> t1'4Castng Volume Multiplier: 0.16 for 2% 0.63 for 4", 1.47 for 6" <br /> t g method.- SubmRermble pump Bailer Centrifugal Pump Other <br /> -At least Well volumes have been evacuated before sampling. <br /> Tubing(type, ww. (new or prevwusly used) was used to purge well <br /> Sampling method: Disposable ba0er Sampling port <br /> Samples collected Sample appearance <br /> Note any sampling problenxs <br /> GROUND WATER EVALUATION/STABEUZAMON DATA <br /> cumutaave Volume of <br /> Couductance Water Level Water Removed fmm Well <br /> Time Temperature ('F} PH Units (umnoslcm) (Nearest 0.01 !t) (galians} <br /> G "2 3 <br /> f <br /> f <br /> Comments: <br /> t <br /> 'r ampoi:aaoa(thermal preservattoa) <br /> Form Comtpleted by: Sampled by- <br />