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ff <br /> TTEW <br /> We answer to you. GROUNDWATER SAMPLING FORM <br /> Page I of__1_ <br /> L_4_i1!� <br /> Well Type: <br /> xmonitor ❑ Extraction ❑Other <br /> Dup: <br /> hlS;hlSD: <br /> Job Name: Hukill Gulch hfillsite 414-2009-076 Well Nlaterial: ❑PVC ❑S.S el Other IMPF. <br /> Job Numbcr: 107732 _Phase Bate: t7� l�i�? Time: <br /> �p <br /> Recorded By: <� Sampled By: Vr7/14!� <br /> (Signature) (Sampling Tenet 14embe7s) <br /> PURGE VOLUME + <br /> + PURGE METHOD <br /> Casing Diameter(D in inches):Z _ z Bailer-Type: <br /> Total Depth of Casing(TD in feet BTOC): ❑Submersible❑Peristaltic❑Budder;Pump No.: <br /> Water Level Depth(WL in feet BTOC): Other-Typo:_ <br /> Number of Well Volumes to be Purged, PUMP INTAKE SETTING <br /> Screened/Open Interval in Feet(BTOC)from to ❑Near Bottom ❑Neu Top ❑ Middle of water column 17 Other: <br /> Depth in Feet(BTOC)_ <br /> PURGE VOLUME CALCULATIONS <br /> (— - )X_ z 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 <br /> Time Elapsed (mil Purged (mS/em) (NTUs) (m ) (°C <br /> min} �' ) (mV) Water Comments <br /> (tt Lox.) <br /> o <br /> S <br /> 30 <br /> Note:GT=GrcatcrThan. LT=Less7han. <br /> NNI=Not Measured. NC=Not Colieeted, <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 /> ----------------------- <br /> SAMPLE COLLECTION RECORD <br /> Analysis + <br /> I <br /> Notes: 1r <br /> S00.,.e m e:C16-.' 4 •►•w O., p•dlr <br /> 1 i <br /> Form Printed: May 26,2017 <br />