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Delta <br /> SAINQU YG INFORMATION SHEET Can <br /> >rnvtror��nccttat <br /> suttants,Inc, <br /> sample 1D# � <br /> p -3 Project Name- _ _ Project No p <br /> �` tcaa (address) <br /> r ' bats Sampled: a I lU ! 05 Time <br /> 4 h9a;f Usembly condition- Good Fair Poor(If poor, see comments) <br /> EVi,O pent Replaced. baits lochs locking rap <br /> weftbepth ft below top of casing Casing diameter inches <br /> , df tq water(below Dag of casuigJ "S & Date: 1 / '1"rxne <br /> Ne11'C:adng Volume Multiplier: 0.16 far 2", 0.65 for 4", 1.47 for 6" <br /> 'mag method: Submersible pump Bather Centrifugal pump Other <br /> 'At least well volua=have been evacuated before sampling. <br /> Tubmg(type: _ (new or previously used) was used to purge well <br /> Sampling method: Disposable bailer Sampling port <br /> Samples collected Sample appearance <br /> Nola any sampan# problems <br /> GROUND WATER EVACUATIOMSTARIIJ AMOK DATA <br /> * Cumalaave Volume of <br /> " Conductance Water Level Water Removed from Well <br /> 'I"une x Temperatum pH Units (umuodcm) (Neatest 0.41 ft) (gallons) <br /> ( 2- <br /> Comments; zCcmments- <br /> Transportation(thermal prnservatlan) <br /> Form oomplaed by: Sample4 by. <br />