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RETTEW <br /> We answer to you. GROUNDWATER SAMPLING FORM <br /> Page 1 of_1_ , <br /> Well Type: Monitor ❑ Extraction ❑Other Well <br /> Dup; <br /> MSIMSD. <br /> Job Name: Hukill Gulch Miilsite#M-2002-0716 We11 Material: ❑PVC ❑St Steel Other <br /> Job Number: 107732000 Phase Date: _10 j�4 0 Time:_ &2,2 <br /> Recorded By: Alt <br /> �- Sampled By: 129�� <br /> (Signature) (Sampling Team Members) - <br /> PURGE VOLUME „ PURGE METHOD <br /> Casing Diameter(D in inches):z 2 3 Y r -Sailer-Type: <br /> Total Depth of Casing(TD in feet BTOC):��' 11 Submersible❑Peristaltic❑Bladder;Pump No.: <br /> Water Level Depth(WL infect BTOC):----� -- Other-Type: - <br /> Number of Well Volumes to be Purged: PUMP INTAKE SETTING t <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 /> ( —) 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 (mLl Purged nS/cm p <br /> (' ) ��� "�) (mom") (�C) (m� Water (.'m1m1e71t5 <br /> min) <br /> 30 <br /> Note: GT=Gx-ter 7hac. LT-Lan Than, <br /> NM=Nat Measured. NC-Not Collatsd. <br /> OBSERVATIONS DURING WELL PURGING: Well Condition �QO _Color: <br /> Turbidity(Qualitative): Odor. Other: <br /> Purge Water Disposal: ❑San.Sewer ❑Storm Sewer ❑Bucket:Type Size_ Other: i <br /> SAMPLE COLLECTION RECORD <br /> Analysis <br /> Notes: <br /> fI <br /> I <br /> i <br /> E <br /> I <br /> Form Printed: October Y,2017 <br />