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i <br /> RE TTE W <br /> We answer to you. GROUNDWATER SAMPLING FORM <br /> Pagc 1 of_1__ <br /> Well Type: Monitor ❑ Extraction ❑Other Well d0.:__ <br /> Dup. <br /> p�^ MSJiVISll: <br /> Job Name: Hukill Gulch Millsite#.M-2009 07C Well Material: ❑PVC ❑St.Steel �rTOther <br /> Job Number 17732 0 hase llatc: _ Y ?OIL �� <br /> �-.�_ l/ Time: Zn <br /> Recorded By:_�! Sampled By: (c <br /> i <br /> (Signature) (Sampling Team Members) <br /> i <br /> I <br /> PURGE VOLUME <br /> y Pt�6tGE METHOD <br /> Casing Diameter(Din inches):? Bailer-Type: <br /> Total Depth of Casing(TD in feet BTOC): ❑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 o£water column ❑ Other: <br /> 1 <br /> Depth in feet(BTOC) <br /> PURGE VOLUME CALCULATIONS <br /> ( )X zX X0.0408= <br /> TD(feet) WL(feet) D(inches) No.Volumes Gallons <br /> Calculated Purge Volume <br /> FIELD PARAMETER MEASUREMENT <br /> i <br /> Minutes Kate Gallons pH Cond. Turbidity DO Temp. ORP Depth to <br /> Time Elapsed {mL/ Purged (MSJcm) (NTUs) (ntglL) (°C <br /> min) ) (ntV) Water Comments <br /> i <br /> i <br /> i <br /> 5 <br /> i <br /> i <br /> t <br /> I <br /> 30 I <br /> Note:CT=GrcaterThan. LT-Less Than. - 1 <br /> NM=Not Measured NC=Not Collccad. <br /> OBSERVATIONS DURING WELL PURGING: Well Condition: <br /> _Color: <br /> Turbidityi <br /> (Qualitative): Odot: Other: <br /> Purge Water Disposal: ❑San.Sewer ❑Storm Sewer ❑Bucket:Type JSize <br /> SAMPLE COLLECTION RECORD j <br /> Analysis <br /> Notes: J <br /> hp <br /> l � <br /> i <br /> i <br /> Form Printed: August 30,2017 <br />