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I � <br /> GROUNDWATER PURGE AND <br /> �,(/`� SAMPLE FORMProject Name _ ! _ Well No ✓L 11L) / Date `� l <br /> Project No 1 J��l- / / [�C� Personnel <br /> I <br /> GAUGING DATA <br /> Water Level Measuring Method I/1�rfQ-Ce rcrQ }o Measuring Point Description ��G <br /> Casing Total Req'd <br /> WELL Total Depth Depth to Water Water Column Multlpllerfor Volume Purge Volume <br /> VOLUME (fest) (feet) (feet) X Casing Diameter (gal) (gal) <br /> CALCULATION — <br /> 076 064 144 <br /> PURGING DATA <br /> Purge Method Y Q GV V rn �C� C Purge Depth _S_��CC/"� Pur e Rate '7 <br /> ,. g I <br /> Time <br /> �., ry - - �� �D� 100(4,) l oa? <br /> ,� --tet <br /> IY -Volume Purges(gal}_K <br /> "Temperature(°C} ;. w 9 a- y /'�? <br /> _ <br /> t Specrfic Condvctivrty{umttos)r y /fir <br /> Turbfdrt)�Color rc <br /> Ddor x a- "y 1-44 i A10 <br /> .� t:. es 447 O 1 Casrng Volumes~Removed�� <br /> � f)f <br /> Dewatered?= ~s"^'u ,*.�` v> <br /> Comments/Observations <br /> SAMPLING DATA Time Sampled 0l�� ApProx Depth to Water During Sampling <br /> g <br /> Comments <br /> r - Volume N V Shipped Under Cham <br /> Sample Number of Container Z. Filled of Custody at 4°C Analysis "- <br /> Number Containers Type Preservat ve mL or L Turbidity Color iN Method -_Comments <br /> Ma- //G! �Ur L v c u 4►t -r n <br /> x � <br /> Total Purge Volume ? li7'Z Disposal/Containment Method _ '>'C€R 720 ���t✓ <br /> eather Conditions <br /> ondition of Well Box and Casing at Time of Sampling �c. <br /> Weff Head Conditions Requiring Correction(locks,damaged casing or well box,etc) D <br /> Problems Encountered Dunng Purging and Sampling <br /> Comments <br /> PM5 PRW TEMP FoFlMS PURGE1o96 <br />