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<br />GROUNDWATER SAMPLING RECORD PAGE: ~ ot: <br /> SAMPLE NUMBER: <br />Project No: Sr-1 tel - 2 Project Name:_1 ~c_.FC2 \49`1 C-OtD Ntt.L >,nw~ Sk+AP. Date 3125 / 95 <br />Sampling Location (well ID, etc.): ~~?~L A <br />Starting Water Level (ft. BMP): _~/~ <br />Sampled by: /VIES Total Depth (ft. BGL): Water Column t (ftl: _ <br />Measuring Point IMP) of Well: TOC. Casing Diameter (in ID): _ M ication Factor: <br />Screened Interval (ft. BGL): Casing Volume (gal.): X: 3X 4X <br />Filter Pack Interval Ift. BGL): Water Level If PI at End of Purge: <br />Casing Stickup (ft.): Total th (ft. BMP) at End of Purge: <br />LECTFJS SPMP1.~ D tRsLTI'~( <br />GoI <br />''O ~`'~G\>J6 <br />. <br />' <br />QUALITY ASSURANCE <br />F~cFn Sc(~~CE <br />METHODS (describe): ~` <br />y <br />~ <br />~ <br />AICCUG)C~TAP H ~ W!tS!\ <br />t>~STtU~ 1-E,A ~~..1 F <br />Cleaning Equipment: <br />Nl~b s R~~~ <br />Purging: p~~\CA ~~ I~~~E~ ~ taltpl.~ Qc.F'CSampling: " <br />Disposal of Discharged Water: n~SCtan~t-,E~ -TO 6Rey~11~ <br />INSTRUMENTS (indicate make, model, i.d.): <br />Water Level: 'SGUr.tS-C t01 -3~C Thermometer: AzC P~'C~E <br />pH Meter. c2~c~1 25aA Field Calibration: y ~ } P'H ew(-~~S <br />Conductivity Meter. [',p. ~y$1-~~ Field Calibration: 1Ufd~ At..thos ~CJ-1 S't>J~ <br />Filtration: O X15 ts, - t~1E ptS ~ShQL~ Other: <br />SAMPLING MEASUREMENTS <br /> Purge Characteristics Water Quality Data Appearance <br />Datel <br />Time <br />Cumul.Vyl. <br />Purge <br />Temp. • Specific Conductance <br />Ilrmhoslcm) <br />l <br />Turbidity <br />Remarks <br /> R 'C pH or <br />Co di <br />& S <br />t <br /> (pelf L ate Igpml 1 <br />I @ Field Temp. @ 25' C. men <br />e <br />9 4 tb ~ - 3.3 2 Pnw) Tc1 <br /> is S <br /> <br /> <br /> - «~ o E F= <br /> <br /> \T ^' S <br /> PAC Ca Tta <br /> Water Level (ft. BMP) at End of Purge: Sample Intake Depth (ft. BMP): <br /> SAMPLE INVENTORY <br /> Bottles Collected <br /> Filtration Preservation Remarks <br /> Time Volume Composition (glass, plastic) Quantity IY/N) (type) (quality control sample, other) <br /> 94D 2, `{ a1G F~ ~-iE~ <br /> 9`+0 U S-C <br /> <br /> <br /> <br /> Chain-of-Custody Record No. 1y.F~ c.O.C.. ~ H152Z MCCULLEY, FRICK & GILMAN, INC. <br /> 4900 PEARL EAST CIRCLE <br /> <br /> ABBREVIATIONS: SUITE 300W <br /> BMP -below measuring point C -Celsius BOULDER, C~ $030 <br /> BGL -below ground level gal. -gallons <br />Cumin. Vol. -Cumulative volume removed gpm -gallons per minute <br />(303) 447-1823 <br /> ID -Inside Diameter in. • Inches <br />M:\G EN E RAt\FO RM SIG RDNTR. SMP <br />