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RE TTEW <br /> We answer to you. GROUNDWATER SAMPLING FORM <br /> j� Page 1 of—I <br /> r/tlwh(�r.i.,j <br /> Well Type: Monitor ❑ Extraction 13 Other Well No.: <br /> Dup: <br /> �f MS/i1fSD; <br /> Job Namc: Huldll Gulch Millsite m-2009-076 Well Material: ❑PVC ❑St.Steel Other t f <br /> Job Number. l0 732000 --^ Phase Date: ��t (Z��f t <br /> / Time:� <br /> Recorded By: �34 Sampled By: f3la 4 <br /> (Signature) (Sampling Team Members) i <br /> PURGE VOLUME fe PURGE METHOD <br /> Casing Diameter(D in inches):? , 12-Sailer-Type: <br /> Total Depth of Casing(TD in feat BTOC): z ppp3'� r ❑Submersible❑Peristaltic❑Bladder;Pump No.: i <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 2 x 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 Time Elapsed (mu Purged QnS/cm) (NTUs P i <br /> min) <br /> (mglL) (°C) (mV) Water Comments <br /> (ft t.o.c.) <br /> 15 <br /> 18 <br /> 21 <br /> 24 <br /> 27 <br /> 30 <br /> Note: GT=GreaterTlnn. LT=LemThmt. <br /> NNf=Net Measumd. NC=Not Collected. <br /> OBSERVATIONS DURING WELL PURGING: Well condition:__�/J <br /> Turbidi �t// Color: <br /> ty(Qualitative):_ Odor: Other; - <br /> Ptrrge Water Disposal: ❑San.Sever ❑Stoat Sewer El Bucket:Type Slze, Other: <br /> SAMPLE COLLECTION RECORD <br /> Analysis <br /> Notes: <br /> )try )-,P:54�c <br /> Form Printed: April 28,2017 <br />