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i <br /> RE TTEW i <br /> We answer to you. GROUNDWATER SAMPLING FORM <br /> Pagel of_I <br /> �9�rN(�C <br /> Well Type:." Monitor ❑ F,xtraction ❑Other ( Well No.: i <br /> ntrP: <br /> Job Nante: Hukill Gulch Milisite#h1-2009-076 Well Material: ❑PVC ❑St.Steel Other <br /> Job Number: l 773 00 Phase Date: __ ©4125r/PZ Time: O _ <br /> Recorded By: Sampled By: <br /> (Signature) (Sampling Team Members) <br /> PURGE VOLUME V PU,RGE METHOD <br /> Casing Diameter(D in inches): L Bailer-Type; <br /> Total Depth of Casing(TD infect BTOC: 2 3 ❑Submersible❑Peristaltic❑Bladder,Pump No--- <br /> Water Level Depth(WL in feet BTOC): Other-Type: <br /> Number of Well Volumes to be Purged: PUMP INTAKE SETTING <br /> Screened/Open Interval in Feet(BTOC)froth to ❑Near Bottom ❑Near Top ❑ Middle of water column ❑ Other: <br /> Depth in feet(BTOC) <br /> PURGE VOLUME CALCULATIONS <br /> ( X 2X X 0.0408_ __ Gallons <br /> TD(feet) `WL(feet) D(inches) No.Volumes Calculated Purge Volume <br /> FIELD PARAMETER MEASUREMENT <br /> Minutes Rate Gallons pH Cond. Turbidity DO Temp. ORP Depth to <br /> Time Elapsed (m1J Purged (mS/cm) (NTUs) (mg/L) (°C) (mV) Water Comments <br /> min) <br /> (ft t.o_c.) <br /> 1 <br /> S <br /> 24 <br /> 30 <br /> Note: GT=GecatcrThan. LT=Less Than. <br /> NM=Not Afaastued. NC=Not Collectcd. n <br /> OBSERVATIONS DURING WELL PURGING; Well Condition: pr( Color.____ <br /> Turbidity(Qualitative). Odor: Other. <br /> Purge Water Disposal: ❑San.Sewer ❑Storm Sewer ❑Bucket:Type Size Othet- <br /> SAMPLE COLLECTION RECORD <br /> Analysis <br /> Notes: <br /> y ` 14 P y,o:f�[. 0^ f7�ba <br />