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GROUNDWATER SAMPLING RECORD SAMPLE No. <br /> Project No: Location: Page 1 of ( <br /> a to— o c:)i /" c C_ Pu e h(o (-7/�rv� <br /> Date: Weather Conditions: Personnel: <br /> V-5 /1 $ C (�p� Gl,,, L!o ' i r-n-• 1oS2 �!__ Jl,V4fCJ <br /> Comments: <br /> INSTRUMENTS USED <br /> Instrument Manufacturer/Model Serial No. Calibration <br /> water Level Prove I, ?' S E,<S f CG e 7 <br /> OH Meter `d , /,n 3.z Sid: 4 5) 10 0 /? 'C Reading -7.0 Sim&: <br /> PH Meter Sid:0 7 10 0 122 "C Reading y1 <br /> speeft Conductance Meter Y S f P,- . /a 3 U j `i 7 std. /N d 3 uS Q 25°C Reading 3 <br /> Specific Conductance Meter Sid: uS C 25`C Rearing <br /> T `/S ! fro /a 3 Q stl 7 <br /> Other. <br /> Filtration 0.45 micron in-line high capacity disposable filter. <br /> WELL PURGING INFORMATION <br /> Casing Diameter(ndtes: 2 borehole Diarnetor tind►es): (o Screened Intawat(tt.BGL)= 3D.t4 - S�•`/ <br /> Depth to Water(R below MP): c-f O. 1 L7 ITOWDepth(ItY 511 7 w-'—(pat): .3. (Cam 1 S=MOO;2'=0.16:v 0.65) <br /> 1,400w : 26 10 e- ra/ <br /> Comments: ModWrhW point(MP)is ON top or tie PVC wen casing• <br /> Depth to SpoaOc <br /> Dater Vol.Purged Water Conductium Temp Appearance <br /> Time pal (feet bear.1r7 PH r.8 23 ieo CI d C color,sediment aloe) Comments <br /> 9: — LI0,z <br /> //:I . f L!/. 7-2 Cam. S C/ZuA- ("c.. <br /> It L1C,2'-f 1 Lt. S/. Cry,.. <br /> Cummuwm Vdww P : �!,Y ores 3. 1 <br /> WELL SAMPLING INFORMATION <br /> SamplinglEguipment <br /> Comments: <br /> SAMPLING MEASUREMENTS: <br /> Depth to Depth Speak Omer Otter <br /> Dater l Water Sampled Cortducimce Tam <br /> Time (ties eew..uvf (teat boa.up) PH rv3 m 23 4"C( Jdeq C) Comments <br /> 12.:045 Lf1.'71- Spt (,.CG L476S 1 .0 <br /> SAMPLE HANDLING: <br /> Dated 0/3 Filtered Preserved <br /> Tine Voumro( Bottb cornposition O (YIN) ) Comments <br /> 12:0 45.5o L.nPF_ 1 Y Hrvo, <br /> 12 25'0 L 0 Pr. 1 N to Sa <br /> r 2:QC) S m co L r-)P t- I N t'4 m A.C. <br /> Field QA/QC Samples Collected Sample No. : hJ <br /> Equipment Decontamination: <br /> Afc.,Q t <br /> Waste Di8 l: V✓al�.- fi �r .. S.,<;,r. <br /> Sotahxeof Fleid P - , �» , CLOSE CONSULTING GROUP LLC <br /> -�--- -� Windsor CO 970 290-6239 <br />