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ITNEW <br /> We answer to you. GROUNDWATER SAMPLING FORM <br /> � Page 1 of i <br /> 14Fj'j j <br /> Well Type:,Z Monitor ❑ Extraction ❑Other Well No.: <br /> — - Dup'-- -- <br /> MS/MSD__ <br /> Job Name: Hukill Gulch Millstte 04-2009-076 Well Material: ❑PVC ❑St. t e ' Other <br /> Job Number. 107732000 Phase Date: Q �� Time:Grp <br /> Recorded By: Sampled By: <br /> (Siguntttre} (Sampling Team Members) <br /> PURGE VOLUME a PURGE METHOD / <br /> Casing Diameter(D in inches):7 l� ,Htailer-Type: 04 <br /> Total Depth of Casing(TD in feet BTOC)-_zs; ❑Submersible❑Peristaltic Bladder;Pump No.: <br /> Water Level Depth(NN'L in feet BTOC): .L''_ Other-Type: i <br /> Number of Well Volumes to bePurgcd. PUMP INTAKE SETTING <br /> Screened/Open Tnterval 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 /> Minutes Rate Gallons pH Cond. Turbidity DO Temp. ORP Depth to <br /> Time Elapsed (mU Purged (mS/cm) (NTUs) (mg/L) {°C) (mV) Water :Comments <br /> minj (ft t.o.c.} <br /> i <br /> i <br /> 3 <br /> 18 <br /> 24 <br /> 27 <br /> 1 <br /> 30 <br /> Note: GT=GrealerThOn. LT=Less Than. <br /> NM=Not Measured NC=Not Collected. <br /> OBSERVATIONS DURING WELL PURGING: Well Condition: 4,oC.P <br /> Turbidity(Qualitative). Color: <br /> Odor (lthcr <br /> Purge Water Disposal: ❑San.Sewer ❑Slorm Sewer ❑Bucket:Type Size_ Other. I <br /> SAMPLE COLLECTION RECORD <br /> Analysis <br /> I <br /> Notes: <br /> 4U' l/� (�A_I 1'VQS�' , L✓wL'�TwC/r � /7GGd�v[.— 6`/ �;�r � <br /> be .� 1nr twCt I.- G�iy U <br /> I <br /> Form Printed: June 29,2017 <br /> E <br /> f <br />