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HETTEW <br /> We answer to you. GROUNDWATER SAMPLING FORM Pagel of_I— L j <br /> ,r Well o.: <br /> Well Type: ,u Monitor ❑ Extraction ❑Other MS <br /> MS/M.Sll: <br /> Job Name: Hukill Gulch Millsite#iM-2009-076 Well Material- ❑PVC ❑S S i/ ❑ Other �� _ <br /> Job Number: 107732000 Phase Date: _ 1J t� r6 Tim I <br /> Recorded By '� �^ Sampled By: <br /> (Signature) (Sampling Tenet Members) <br /> i <br /> PURGE VOLUME ., PURGE METHOD <br /> Casing Diameter(D in inches): ailer-Type: I G 4' x J7 -_ I <br /> Total Depth of Casing(TD in feet BTOC):ZT.3 D Submersible❑Peristaltic❑Bladder;Pump No.: ` <br /> Water Level Depth(WL in feet BTOC): OY7 Other-Type: <br /> Number of Well Volumes to be Purged: PUMP INTAKE SETTING <br /> Screened/Open Interval inFeet(BTOC)from to ❑Near Bottom ❑Near Top D Middle of water column ❑ Other: <br /> fw�t Depth in feet(BTOC) <br /> PURGE VOLUME CALCULATIONS <br /> t )x _Z x x 0.0408= Gallons <br /> TD(feet) WL(feet) D(inches) No.Volumes Calculated Purge Volume <br /> FIELD PARAMETER MEASUREMENT <br /> i <br /> i Minutes Rate IMINOM pH Cond. Turbidity DO Ternp. ORP Depth to <br /> Time Elapsetl (rnli sett (mS/cm) (NTUs) (mg/L) (IC) (mV) Water Comments <br /> min) 4,4%6t,„j, <br /> (ft t.o.c.) <br /> z,�c �!s <br /> 12 <br /> 15 <br /> 18 <br /> 21 <br /> 24 <br /> 27 <br /> I <br /> I <br /> 30 1 <br /> Now GT=Gtcater Than LT=less Than. <br /> NM=Not Measured. NC=Not Collected. <br /> OBSERVATIONS DURING WELL PURGING: Well Condition: _color: <br /> Turbidity(Qualitative). _ Odor:------ Other: <br /> Purge Water Disposal: ❑San.Sewer ❑Storm Sewer ❑Bucket:Type Size Other: <br /> SAMPLE COLLECTION RECORD <br /> Notes: <br /> �,,r. �v I ZZ 0 j <br /> 1 <br /> Form Printed: October 28,2016 <br />