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GROUNDWATER R <br /> ./ �o/� URGE AND SAMPLE FORM <br /> ORM <br /> Project Nasse _ �� �` o Well No vv Date Z <br /> Project No s� �l- / 0 Personnel <br /> GAUGING DATA <br /> Water Level Measuring Method /ri 71ei-fj2CC R-06�—a Measuring Pant Description �U G <br /> WELL Total Depth Depth to Water Water Column Multiplserfor Casfng Total Req'd <br />' VOLUME (feet) r.r (feet) (feet) Casing Diameter V°fume Purge Volume <br /> CALCULATION X {gal) (gal) <br /> �2 6 <br /> 016 0 6 11 44 1 <br /> PURGING DATA <br /> Purge Method C(-) ( Y' Purge Depth S�CC/ <br /> �} g p Purge Rate <br /> Time <br /> Volume Purges(gal) ' <br /> ;-Tern (°CpH <br /> )' ;,;✓,, '�., "- f !•� ��-' <br /> x <br /> Specific Conductivity(umhos)' <br /> s TurtitdV/Colow f�L'o <br /> w`s � .•'�' . •ted Q'"`�' '`�=`,�'= O <br /> Cas'Q9 Volumes RemovedQ ��," <br /> r-Dewaterea?'— f b (� <br /> r ;>•' 1� <br /> Comments/Observations <br /> SAMPLING DATA Time Sampled boo p Approx Depth to Water During Sampling _'3'"q <br /> �T <br /> Comments <br /> Sample Number of Container Volume Shipped Under Cham <br /> Number Containers Type Preservative `sited of Custody at 4°C Analysis <br /> mL or L Turbidcty Color (YIN <br /> Method Comments - <br /> �� VC�Gt` NclDrr�L c1 r,J CIQ r <br /> x � <br /> Total Purge Volume U—P Disposal/ContainmentMethod Tp <br /> Weather Conditions rJU <br /> Condition of Well Box and Casing at iiwe of Sampling (� <br /> Well Head Conditions Requiring Correction(locks,damaged casing orwell box etc) C7 <br /> Problems Encountered During Purging andSampling <br /> Comments <br /> PMS PRoJ TEtiSP FCAP S-PUPGE1096 <br />