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BE,TTOV. <br /> We answer to you. GROUNDWATER SAMPLING FORM <br /> Page 1 of_l_ <br /> ✓a�'swT- <br /> Well Type: Monitor ❑ Extraction ❑Other Well Nu. <br /> Dup <br /> tt MS/MSD: <br /> Job Name: Hukill Gulch Millsite#M-2009-076 Well Material. OPVC El St. feelOther ITD�E <br /> Job Number_107732000 Phase Date: f77 l l+� <br /> Recorded By: l r Sampled By: pe�.44 <br /> (Signature) (Sampling Team Members) <br /> PURGE VOLUME ? t� PURGE METHOD <br /> Casing Diameter(D in inches):_ .x x �CL$ailer-Type: <br /> Total Depth of Casing(TD in feet BTOC): �y ❑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)from to ❑Near Bottom ❑Near Top ❑ Middle of water column ❑ Other: <br /> Depth in feet(BTOC) <br /> PURGE VOLUME CALCULATIONS <br /> ( )X-'X-X 0.0408= Gallons <br /> TD(feet) WL(feet) D(inches) No.Volumes Calculated Purge Volume <br /> FIELD PARAMETER MEASUREMENT <br /> ---] I <br /> Minutes Rate Gallons pH Cond Turbidity DO Temp. ORP Depth to <br /> Time Elapsed (mIl Purged (mS/cm) (NTUs) (mg/L) (IC) (mV) Water Comments <br /> min) (ft t.o.c) <br /> 21 <br /> I <br /> I <br /> f <br /> I <br /> I <br /> 30 <br /> Not. GT=Greater 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: ❑Srm.Sewer ❑Storm Sewer []Bucket-Type Size_ Other: --- <br /> SAMPLE COLLECTION RECORD <br /> Analysis <br /> I <br /> t <br /> Notes: <br /> I <br /> �R f _ t'1• s...�:Shcis per, �re97L 1 <br /> l <br /> i <br /> i <br /> i <br /> Form Printed: February 28,2017 <br />