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x <br /> ff-UAa 2W,4 GD,l2 M 1 W F <br /> t4mL � ��. QA/QC ]Form <br /> Well De i nation /�'/k/-9 <br /> Date 1 t 2.. M <br /> Inspector <br /> Page 1 of 5 <br /> Piezometers <br /> I. Collection and Recording of Lithology Samples <br /> A. Handling of core or cuttings samples <br /> 1) Collected from surface to total depth? Yes y' No <br /> Reason for <br /> variation: <br /> 2) Samples cleaned of drilling fluids and placed in core boxes <br /> or sample bags at time sample is collected? Yes v <br /> No Reason for variation: <br /> 54"Pt-M�ccaey ¢J&OLU ,s�tQ�r /„ jar A'YC&SS -D"Jhf" aga.iJ_4f!S,PL1K P-Mr Aj <br /> 3) Core- boxes or sample bags clearly marked.with hole <br /> identification number and depth interval represented by <br /> sample. Yes No Reason for variation: <br /> B. --3escription of- cuttings <br /> 1) -Fame of ge ogist desci7ibing <br /> I - cuttings? °'• C. &/Lasem <br /> 2) Sample log prepared prior to removal of samples from drill <br /> site. -Yes No Reason for variation: <br /> II. Well Construction <br /> A. Well location <br /> 1) Well c"1lared. at location staked by Cotter representative? <br /> Yes No Reason for variation: <br /> B. Drilling fluids <br /> 1) T <br /> e(s) of fluid used and interval(s) • <br /> 2 Z = A4k A4 - Hu <br /> Reason for using drilling fluids other than air or air mist: <br /> O DEl2 C.:U 7 N6 .,Q J0 -s-MO f-aE Z.j"GJR-L(_. <br />