ML21120A248

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Cimarron Environmental Response Trust 2014 Design Investigation Report, Field Parameter Form
ML21120A248
Person / Time
Site: 07000925
Issue date: 05/31/2015
From:
Burns & McDonnell, State of OK, Dept of Environmental Quality (DEQ)
To:
Office of Nuclear Material Safety and Safeguards
Shared Package
ML21120A281 List:
References
Download: ML21120A248 (25)
v • d • e


Text

CIMARRON ENVIRONMENTAL RESPONSE TRUST FIELDPARAMETER FORM Sample Location: 39 Purge Date:!L f9:G DepthtoWater (10.1ft.): D80 WellDepth (10 1ft.): R 1 WaterColumn (t0.1ft.): b! Casing Volume (10.1gal.): /d PurgeMethod (pump & type.bailer & type etc.): 3"'WC PurgeStart Time: 6 Purge EndTime: (Note: Sample mustbecollected within 24hours ofpurge time)

Volume Purged: 7 O FIELD PARAMETER LOG Purge i pH j Specific Temperature Dissolved Oxidation/Reduction Volume l l Conductivity (DO) Potential iOxygen (ORP)

(std.

units * (pm/cm to3sig.

l l L -

f  ? l H93 lB ? l l

LO  ?. G l Q83 (V 8 l qf +f S90  :?.%

(,a ?5 SW l b2 L l

Acceptance3samples 3samples 3samples 3samples' 3samples Criteria t 0.1unit 1 10%  ; 1 10% l 1 10% t 10%

a i Sample Date: MM Sample Time: /G2cf Weather: CI)L0 b"N Sample Method (bailer (type), pump(type).

scoop (type). etc.):

(,CC d D905 Sample Appearance: CLAA-L Sampler (print name): bQfrD b M PA Date: /i 'st f Note:Usechain ofcustody form toindicate which sample werefiltered bottles andfHter size.

FormQAlP9.1-2

CIMARRON ENVIRONMENTAL RESPONSE TRUST FIELD P ARAMETER FORM SampleLocation: C Purge Date: i2C /1 DepthtoWater (t 0.1ft.): d5 W WellDepth (10 1ft.): $ '/3 I WaterColumn (10.1ft): G 5'/ Casing Volume (t0.1gal.):  ? 2-PurgeMethod (pump & type bailer & typeetc.):

PurgeStartTime: 12U 5 Purge EndTime: [ (Note: Samplemustbecollected VolumePurged: fA FIELD PARAMETER LOG i Purge Volume l Specific Conductivity Temperature DissolvedOxidation/Reduction Oxygen (DO) Potential (ORP)

(gallons)(std. units t (ym/cm to3sig.

("C t 0.1*) (mg//

1 0.1.) (mV1 1) l 0.1) digits) l l Wq '

Q QO l VL lau y

3.w --

W l iTP - - - -

l l l

l l

l l '

Acceptance3samplesf 3samples 3 samples 3 samplesl 3samples SampleDate: 2 n 11 Sample Time: )z15 Weather: en cav O' SampleMethod (bailer (type), pump(type), scoop (type), etc.):

ap.9vo Pef SampleAppearance: 0ENA Sampler(print name): M Date: it 2L 11 Note:

Usechain ofcustody form toindicate which sample bottles were filtered andfilter size.

FormQAIP-9.1-2

CIMARRON ENVIRONMENTAL RESPONSE TRUST FIELDPARAMETER FORM

!M

, //

i Sample Location: Purge Date: C .

t0 '

toWater Depth (t0.1ft.):  ?"ilb Well (*

Depth 0.1ft.): @

Column Water (t0.1ft.): 19 O 2 CasingVolume (10.1gai.): W-C .

Method Purge (pump & type,bailer & type, etc.): '2%' :J6 A3 Start Purge Time: 4A L Purge EndTime: (Note: Samplemustbecollected a within ofpurge 24hours time)

VolumePurged: >

  • FIELD PARAMETER LOG Volume Purge pH l SpecificConductivity Temperature (gallons)(std.

units t 0.1)(pm/cm to3sig. digits) (*C t 0.1')

%! S'7) jG ( .

Q 3 2- 5^O iG 3

.L --, a 2

' r C '

3 r '

a l

l l

Acceptance 3 sarrrples 3 samples 3samples SampleDate: SampleTime: E Weather:

SampleMethod (bailer (type), pump(type), scoop (type), etc.):

& L.;:.J&c15 SampleAppearance:

Sampler(print name): &h k ' Date: :U f~' %

Note:

Usechain ofcustody form toindicate which sample bottles were filtered andfiltersize.

FormQAIP9.1-2

CIMARRON ENVIRONMENTAL RESPONSE TRUST FIELDPARAMETER FORM Sample Location. A PurgeDate:

Depth toWater (10.1ft.): 5 L 94 WellDepth ):

(t0.1ft d Water Column (10 1ft.): 1T 4. S CasingVolume 7--5 (10.1gal.):

Purge Method (pump & type.bailer & type. etc.): ccW-Wt'"

Purge StartTime: ib Q Purge EndTime: 4i[ (Note:Samplemustbe collected within 24hours ofpurge time)

Volume Purged: '.2 FIELD PARAMETER LOG Purge pH l Specific Temperature DissolvedOxidation/Reductionl Volume Conductivity Oxygen(DO) l Potential (ORP)

(gallons) (std.units t (ym/cm to3sig. .C 1 0.1.

( )

0.1) digits) (mgA10.1.) (mV1 1) l

),(cl

^

N949  ? ;Li4 q,[ l -l >D 5L9 lSL'd C Q.8 G.8 .

S Li aa ^""'"

be'.

ry.4 ec,.%~l l ,

I Acceptance3 samples , 3samples l 3samplesl 3samples l 3samples Sample Date: 1.d?Q Sample Time: 'T Weather:

Sample Method (bailer (type),pump(type). scoop (type).etc.):

2topot03 Sample Appearance:

Sampler (print name): Date: 7 h'- !

Note: Usechain ofcustody form toindicate which sample bottles werefiltered andfilter size.

FormQAIP-9.1-2

CIMARRON ENVIRONMENTAL RESPONSE TRUST FIELD PARAMETER FORM

/ /

Sample Location: ?3P/ PurgeDate:iL //J /'

Ff Depth toWater (1 0.1ft): 5F O9 Well Depth(t0.1ft.):

M 48 Water Column (t0.1ft.): i2.34 Casing Volume (0+.1gal.):

E. 2-Purge Method (pump & type, bailer & type,etc.):

Purge Start Time: C PurgeEndTime: !Cy g' Sample (Note: mustbecollected 24hours within ofpurgetime)

Volume Purged: o 4 FIELD PARAMETER LOG Purge Specific Dissolved Oxidation/Reduction pH Temperature Volume Conductivity , Oxygen (DO) Potential (ORP)

(gallons) (std.units t (pm/cm to3 sig.

( C t 0.1

)

0.1) digits) (mg//1 0.1) (mV* 1)

L Gq 5 )5 lL L gq TC 5? L /G?

[o 5K fG.?

a..a l l

l l

l l Criteria1 0.1unit

, , 1 10% 1 10% , t 10% t 10%

Sample Date: A SampleTime: MW Weather:

Sample Method (bailer (type). pump(type). scoop (type). etc.):

Sample Appearance:

Sampler (print name):  %% b0LTj'#'W Date:

Note:Usechain ofcustody form toindicate which sample bottles were filtered andfilter size.

FormQAIP-9.1-2

CIMARRON ENVIRONMENTAL RESPONSE TRUST FIELD PARAMETER FORM Sample Location: T2t'4 ER @ Date:/fG Purge V DepthtoWater (t0 1ft.):

l% Ob WellDepth(10 1ft.): 3 GI WaterColumn (t0.1ft.): Afl Casing Volume(10.1gal.):2 PurgeMethod (pump & type,bailer & type,etc.): 6 (dU^' DibE PurgeStart Time: 43 O Purge EndTime: A Q O Sample (Note: mustbecollected within 24hoursofpurgetime)

Volume Purged: 13 FIELD PARAMETER LOG Purge pH Specific DissolvedOxidation/Reduction Volume I Conductivity Temperature Oxygen (DO) Potential (ORP)

(std.units * (ym/cm to3 sig.

(gallons) 0.1) digits) (C

  • 0.1) (mgAt 0.1) (mV* 1.)

y q ,

fo ;oli U.0 r

b -

at ze x jo?5 ;J. 3 l

Pj/ lb O [R L?3 l

l Acceptance3samples 3samples 3samples 3samples 3samples Criteria t 0.1 unit t 10% t 10%

  • 10% t 10%

Sample Date:1 lb W SampleTime: A'o'-to Weather:

Sample Method (bailer(type),pump(type), scoop (type).etc.):

Cocco ;JDGo5 Sample Appearance:

Sampler (print name): CTAroU Date:

Note:Usechain ofcustody form toindicate which sample werefiltered bottles andfilter size.

FormQAIP-9.1-2

CIMARRON ENVIRONMENTAL RESPONSE TRUST FIELDPARAMETER FORM v /

Sample Location: T-9 Purge Date:&

Depth toWater (+0.1ft.): j28) WellDepth (10.1ft.): 2I 31 Water Column (10.1ft.): (9 HS Casing Volume (10.1gal.): 3.a Purge Method (pump & type,bailer & type.etc):

Purge StartTime: (335 Purge EndTime: iW (Note:Sample mustbecollected within24hours ofpurge time)

Volume Purged: $

FIELD PARAMETER LOG Purge pH Specific Temperature DissolvedOxidation/Reduction Volume Conductivity Oxygen (DO) Potential (ORP)

(std.

units * (pm/cm to3sig. C

  • 0.1 (gallons) 0.1) digits) ( ) l (mg/I 1 0.1) (mVt 1) 3u ho za yo iS 8 a.u F.t lzcho l's.1 l

) ,Q j,Q Q QQ ;Q ;'

G.0 T L l la 90 t%L" ,

I l

Acceptance3samples Criteria t 0.1unitl 3samples 1 10%

3samples 3samples t 10% t 10%

l 3samples 1 10%

/ /

Sample Date: A Sample Time: (3f0 Weather:coes Sample Method (bailer (type),pump(type). scoop (type).etc.):

Sample Appearance:caa lI Sampler (print name): M Date:4t9;M Note:Usechain ofcustody form toindicate which sample bottles andfilter werefiltered size.

FormQAIP9.12

CIMARRON ENVIRONMENTAL RESPONSE TRUST FIELDPARAMETER FORM Ic SampleLocation:

Purge Date: / /U DepthtoWater (10.1ft.): (29/ Depth Well (t0 1ft.):3t8(

WaterColumn (t0.1ft.): /f/ CasingVolume (t0.1gal.):3/

PurgeMethod (pump & type,bailer & type, etc.):osuu DR'T v o" c PurgeStartTime: C Purge EndTime: 3 (Note:

Sample mustbecollected l .' within 24hours ofpurge time)

VolumePurged: !3U FIELD PARAMETER LOG PurgeVolume pH i SpecificConductivity Temperature (gallons)(std. l units t 0.1) l (pm/cm to3 sig. digits) .

(*C t 0.1*)

i5.2

~ ~

3I g g 2 a ?a t,.2 G>? i OSC IG 3 1.3 a .

J 2 odo l9 .5 l

, l l l l

Acceptance l 3 samoles 3samples 3samples Criterial t 0.1unit 1 10% t 10% .

SampleDate: Sample Time: '4C Weather: coco SampleMethod (bailer(type), pump(type),

scoop (type), etc.):

SampleAppearance:

Sampler(print name): G9MDShDW Date: ;2) !B : i %

Note:Usechain ofcustody form toindicate which sample bottleswere filtered andfilter size.

FormQAIP-9.1-2

CIMARRON ENVIRONMENTAL RESPONSE TRUST FIELDPARAMETER FORM SampleLocation: C Purge Date:i? I'iG

!!N DepthtoWater (t0.1ft.): g 23 .

Well Depth  ?/.4G (t0.1ft.):

WaterColumn (t0.1ft.): g[22 CasingVolume 3.0 (t0.1gal.):

PurgeMethod (pump & type, bailer & type, etc.): sw~oPos PurgeStad Time: C Purge EndTime: A (Note: Sample mustbecollected within 24hours time) ofpurge volumePurged: !EC FIELD PARAMETER LOG pH PurgeVolume SpecificConductivity Temperature (gallons)(std., units1 0.1)(pm/cm to3sig. digits) (*Ct 0.1*)

LO 3 .

32^$ c y 3 o o 9 2. 373 o /G.3

?# 1L 2 2 Lo (G 3 Acceptance 3 samples 3 samples 3samples Criteria t 0.1 unit t 10% t 10%

t t SampleDate: Sample Time: W V L-Weather:

SampleMethod (bailer (type),pump(type), scoop (type), etc.):

SampleAppearance:

Sampler(print name): Date:PI ! Y Note:Usechain ofcustody form toindicatewhich sample bottles were andfilter filtered size.

FormQAIP-9.1-2

CIMARRON ENVIRONMENTAL RESPONSE TRUST FIELDPARAMETER FORM

-- /

M Sample Location: 7 -

. 03 Purge Date:

Depth toWater (t0 1ft.): (1Q~! WellDepth (t0.1ft.):'T b y U',,

CasingVolume (1 0.1gal.):"'

Column Water (10.1ft.):E Method Purge (pump& type.bailer & type,etc): CA#d G T03 Start Purge Time: '- l3L Purge EndTime: tLST (Note:

Samplemustbecollected within 24hoursofpurgetime) volume Purged: TD FIELD PARAMETER LOG Purge Volume pH SpecificConductivity Temperature !

.oD lb i O [(ofJ [J lO

, c /, t I G53  !-AA' ED (D G $ 5'"

~

Es9 IT l , l l l Acceptance 3 samples 3 samples 3 samples Criteria t 0.1unit 1 10% t 10%

Sample Date: I1- !7 /V SampleTime: /!'R Weather:

Sample Method (bailer(type), pump(type),

scoop (type), etc.):

G py a /N Sample Appearance: C C24--

Sampler (print name): Date:/ E-:7 9 Note:

Usechain ofcustody formtoindicate which sample were bottles filtered andfilter size.

FormQAIP-9.1-2

CIMARRON ENVIRONMENTAL RESPONSE TRUST FIELDPARAMETER FORM Sample Location '*Th~ -

2-A& Dap Purge Date:M Depth (*

toWater 0.1ft.): 16 WellDepth (t0.1ft.): "?E6 /

Water Column (10.1ft.):A CasingVolume (10.1gal.) 7 O Purge Method (pump & type.bailer & type. etc.): ocuadD93i Purge Start Time: LO Afo Purge EndTime: LOSQ (Note:Samplemustbecollected within24hoursofpurgetime)

Volume Purged: E FIELD PARAMETER LOG Purge Specific DissolvedOxidation/Reduction pH I Conductivity Temperature Oxygen Volume (DO) Potential (ORP)

(std.units t (ym/cm to3 sig. . t .

(gallons) 0.1) digits) (C 0.1) '

+ 0.1)

(mg/I (mVt 1)

,. 7i ,

G G* , "

D' Cf t i; l

p , Q Q i

$' f '

fV '> , 3 L fm tt y +

. Q .

[0 co f G.Q l

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3samples l 3samples 3samples 3samples Acceptance3samples Criteria t 0.1 unit

  • 10% l
  • 10% l 1 10% 10%

t Sample Date: SampleTime: ;o$1 Weather:

Sample Method (bailer (type), pump(type). scoop (type) etc):

rs Sample Appearance:

Sampler (print name): Date: W Note: Usechain ofcustody form toindicatewhich sample werefiltered bottles andfilter size.

FormQAIP-9.1-2

FIELD GROUNDWATER SAMPLING REPORT

  • ! v ,

DATE: Wi0M SITE: c,'xe.//o's PIDREADING atWELLHEAD(ppm): # E v

PROJECT NUMBER: T>11 . .m WEATHER:

a w WELLNUMBER DEPTHTOWATER(ft btoc):1 dbCoJPA 710 -

- , c ,

TOTALDEPTH(ft btoc): !TAs 12CASINGDIAMETER (inches): L PURGING WellVolumeCalculation p-1 well volume (gallcns) = initial height ofwater column (ft) -

  • 00408* (casing diameter (in))2

,-- 3 Equipment Used:(Bjladder Pumf) (Bailer) Other Equipment Dedicated: yes /jRp Time Amount

. Flow Specific Temp. Conductivity Turbidity l ORP D.O. Depth to Purged Rate pH '

Water Observations (24 hr) (gals) (ml/min) (=C) (pS/cm) (NTU) x (mV) (mg/L)(ft BTOC)ot.#owga.g j Sp, - - - i -

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,-m SAMPLING Equipment Used:($ame dis above-Qther Flow Time Amount SpecificTurbidity i ORP D.0 Depth Temp~ Conductivity to I I Purged Rate pH '

Water Observations I (24 hr) . .

(C) c (NTU)(mV)(mg/L) ,

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C feed. l IDWTOTAL: .cOho ;

SAMPLEID: df"WA& P . s SAMPLEIDFORQC: N4.

PARAMETERS REQUESTED FORANALYSISE 802 PRINTNAME w-uwy SfGN#ATURE'

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FIELDGROUNDWATER SAMPLING REPORT

/ a SITE:'^wo-Y atWELLHEAD(ppm):

A PIDREADING "

DATE: i t L m

PROJECT NUMBER: f C$(

/3. WEATHER:/ ' 4' v ., -

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'0v WELLNUMBER DEPTHTOWATER(ft btoc): 0 b

/f  ?-M#c A-- ap s 20 A L

u TOTALDEPTH(ft btoc): CASlNGDIAMETER (inches):

PURGING ell Volume Calculation 1 well volume (gallons) = initial height ofwater column (ft)

  • 0.0408 *

(casing diameter (in))2 Equipment Used: (@dder P rdp) (Bailer) Other Equipment Dedicated: yes/@

Time

. Amount Purged Rate Flow pH I Specific Temp. lConductivity Turbidity ORP l D.O. Depth Water to Observations (24 hr) (gals)(ml/min) (C) (pS/cm); (NTU) (mV)(mg/L)

(ft BTOC) 1/,g r - -

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SAMPLING Equipment Used:

@rne asabov4 Other Time Amount Flow Specific Temp.IConductivity i Turbidity I ORP D.O. Depth to l Rate pH hr) Purged l Water  : Observations (24 (gals)(ml/min) ('C) (S/cm) (NTU) (mV)(mg/L)(ft BTOC) ,

(a a l(, 7v  ; !g

, +71 [o IDWTOTAL:

SAMPLElD: W'M db SAMPLEIDFORQC: W PARAMETERS REQUESTED FORANALYSIS:

q;eomm p , as;catacey, pe,,'u--

PRINTNAME SIGNATURE DATE

.4 1, , c s ,-'  ; r PREPARED: '.,

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FIELD GROUNDWATER SAMPLING REPORT SITE:b- atWELLHEAD(ppm): UA DATE:

- A Ma /'s x PlDREADING m m .m -, -

PROJECT NUMBER:W WEATHER:

4 v-WELLNUMBER DEPTHTOWATER(ft btoc): 7, 64 r- -- rq l  ;

DA TOTALDEPTH(ft btoc):  ! CASING DIAMETER (inches): 2 PURGING ell Volume Calculation 1well volume (gallons) = initial height ofwater column (ft)* 00408* (casing diameter (in))2 Equipment Used: (Bladder Pump)(Bailer) Other Equipment Dedicated: yes/ho Time

. Amount Flow l Temp Specific Turbidity I ORP D.O ' Depth to Purged Rate I pH I Conductivity -

Water Observations (24 hr) (gals) l(ml/min) ) (=C) (pS/cm) (NTU) (mV) - TE)(ft BTOC) I a a e.. -

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SAMPLING Equipment Used: (ame asabo@ Other

<j ORP D.O.! to I Time Amount Flow Depth Temp. Conductivity SpecificTurbidity Purged Rate pH I Water i Observations (24br) (gals)

(mI/min) (*C)I (S/cm) i (NTU) (mV)> (mg/L) I

(ft BTOC)

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IDWTOTAL. -

SAMPLEID:D.? v)

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i PARAMETERS REQUESTED FORANALYSIS: ';

p-ww;::4 p L ,;g em us-w,-, , ssfu PRINTNAME SIGNATURE ,

DATE j1 " --' -

PREPARED:M ""-

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FIELDGROUNDWATER SAMPLING REPORT DATE: SITE: -r^< ana 's PIDREADING atWELLHEAD(ppm): /"E PROJECT NUMBER:  % ,

"t ? WEATHER: !t^ -

A9 a

/D 5 L L2 @

l. a T-WELLNUMBER DEPTHTOWATER(ft btoc): '

1 -

S 9 7 a ,.p m "

TOTALDEPTH(ft btoc): 3 : 3 < '

CASING DIAMETER (inches): w PURGING ell Volume Calculation a W 1well volume (gallons) = initialheight ofwater column (ft)

  • 0.0408 *

(casing diameter (in))2 Equipment Used: @dder Pu) (Bailer) Other Equipment Dedicated: yes/60)

I Flow Time Amount Temp.

Specific ORP D.O. Depth to Turbidity pH (24 hr) Purged (gals) (ml/min)

Rate (C)

Conductivity (gS/cm) (NTU) (mV)(mg/L) I l(ft Water BTOC)

Observations

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SAMPLING Equipment Used:Sameas abovd' Other Time Amountl Flow SpecificTurbidity Depth to pH Temp. Conductivity ORP D.O. Water (24 hr) Purged I

I i (gals) (ml/min)

Rate

("C) (S/cm)

I

! (NTU)(mV) JTOb (mg/L) Observations c of IDWTOTAL: U < a.c '

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PARAMETERS REQ UESTEDFORANALYSIS:

PRINTNAME w-wonwrmes SIGNATURE DATE PREPARED: A,b^Ew bee)wb

FIELD GROUNDWATER SAMPLING REPORT DATE: SITE: PlD READING atWELL HEAD(ppm):1t PROJECT NUMBER: 2N WEATHER:

WELL NUMBER DEPTH TOWATER (ft btoc);1 w

PURGING TOTAL DEPTH (ftbtoc):M CASING DIAMETER I~

(inches):

Volume ell Calculation V

1well volume (gallons) height ofwater column

= initial (ft)n* 0.0408 *

(casing diameter (in))2 Equipment Used: (Bailer) Other Equiprnent Dedicated: yes

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The Amount Flow Specific Temp. Conductivity Turbidity ORP D.O. Depth to (24 br) Purged Rate fm pH (C) (gS/cm) (M (mV) (mg/L) Water Observation BTOC)ot#alpef (ft m - -.- - c -

- - d[, of h e-s et OtS O 0,44 h tLM 4

  • 2.J 4 StA be c 3 - is F 4 A.% X 8 VC 44 f of Lew

% m ** A45 I 2L,J*f% a4 CLW

% )3 L ~ L## 0*(f "A th # *T C *40 S - eo t4 v.51 31 N SS c,5 a c4ts t - tea 4.4 a.is t t -4 t 1,f *. V .*7  %

I 45 - too 4 o .5 08 A D 40 .o% th i toe (,A4 o. O if A- Q'T Cleat one)-- --

Contjnued onbackfcircle yes/ o S.Ayl.PJLjN.G Equipment Used: ther he Amount Flow SpecificTuay Temp. Conductivity W D.0' Depth to ,

pH Water (24 hr) Purged(gals)(ml/min)

Rate N (S/cm)(NTU)(mV)(mg/L)(ft BTOC)

Observations 1 ,

o o0-. of 0 41 I A bY Y ,

C C IDWTOTAL:

SAMPLE ID: SAMPLE IDFORQC: M PARAMETERS REQUESTED FORANALYSIS A'M 50$

at*Weemry, ,

PRJNINAME TURE DATji[

PREPARED: @. . -

FIELD GROUNDWATER SAMPLING REPORT DATE: d SITE: ***vr*% PIDREADING atWELLHEAD(ppm):2 PROJECT NUMBER:M WEATHER:

WELLNUMBER DEPTH TOWATER (ftbtoc): 63 u

TOTALDEPTH (ft btoc): CASING DIAMETER (inches):1-PURGING ellVolume Calculation V C 1welf volume (gallons) height ofwater column

= initial (ft)L*

  • 00408(casing (in))2 diameter Equipment Used: p)(Bailer) Other. . -

Equipment Dedicated: yes/SI Time Amount Purged Rate Flow pH Temp. Specific Conductivity Turbidity ORP D,0. Depth to Water Observation (24 hr) gfm (C) (gS/cm) 9# (ft BTOC) 16$r w - - T -

' - - / .to rcree- cato 1.e -

t*e 7 af 4 -

StP Y to t/#ey/.Jew LTo4 - Ipe &4 Lt I , ~

R ( /3,

  • 4tedA I u - ea t Lt.'t ( - r 4 I ar 3,so ctw TIG -

L** 4,* S. 9C ~ -

9 .1 o. s31a Cs,-

2- - , q a 1 6g -

~9 , 6,(, ( o cto

- ** 1 6:% 7 8 * "J* A C o < leav

% A too

  • a -

%t U %t o L Continued onback M ..,, -

SAMPLING Equipment Used: Other Depth to Time Amount Flow Purged Rate pH Specific TemPConductivity Turbidity ORP D.O. Water Observations (24 hr) (gals)(mI/min) (*C) (S/cm)(NTU)(mV)(mg/L)(ft BTOC)

I* A VA A I40 (it .Q -

0#f I7,a CJ(ear-JDWTOTAL:

SAMPLE ID:@ .- SAMPLE IDFORQC:V3l~

PARAMETERS REQ UESTED FORANALYSIS:

PRINT NAME S.IGNATUURE DAJE[

PREPARED:Mrma2*A

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