HYDRO28727

• Permit No: C1981015
• IBM Index Class Name: Hydrology
• Doc Date: 3/21/1981
• Doc Name: WATER SAMPLE COLLECTION FORM
• Permit Index Doc Type: OTHER GROUND WATER
• Media Type: D
• Archive: No

W ER SAMPLE COLLECTION FORM • III IIIIIIIIIIIIIIII
' ~ sss
;; ~ Date ~fla.re..1~21 i98r .
Name of Person Taking Samples ~ ~„~ ~.So{..TESCQ~
i
Surface Water
Monitoring Location Ground Water
Monitoring Well No. Depth to
Water Level No. of
Samples °C
Temp.
1. CM-l ! o~~o~~ r 1~{

a. Cn1-'~ 159 ~ !1 ~~ 1 ~ z
s. Cm-~ 1~~~ 5~~ I 3
s. M_~ ~, ., ~ 9

a. m _ 3 p,,~Y _.-. -

9•
Near r-1- I A p Q . l e•~s :.rt
s j-,.~.4,,~
-
1
2
lo.
11.
12.
Ground Water Monitoring Well Information:
Well Designation Strata Penetrated Depth Perforated interval
~~