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WATER SAMPLE COLLECTION FORM • III I ll~l~l~ll <br />t~ <br />Date ~e.~.l`},1981 <br />-~ <br />Name of Person <br />Taking Samples ~a.,-~~S! .,c,~,,,,e ~So~.TCSCO~ <br /> Surface Water <br />Monitoring Location Ground Water <br />Monitoring Well No. Depth to <br />Water Level No. of <br />Samples ~ <br />Temp. <br /> <br /> <br />3. G-'VI-~J 171f 3~~ ~ 1~ <br />4. GM-T IL.2~o" Z 11 <br />5- GM-? 138~3~~ 2 12 <br />s. M_~ 3S o•' x, , o <br />~ M-z d~ <br />8- <br /> <br />9• <br /> <br />Nea.r~ M- l lYl-3 c1r~ <br />A,pP. ~ ~~s <br />4~ ~+«4.N, <br /> <br />z <br /> <br />t <br />lo. <br />11. <br />12 . <br />Ground Water Monitoring Well Information: <br />Well Designation Strata Penetrated Deoth Perforated Interval <br /> <br />