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GROUNDWATER PURGE AND SAMPLE FORM <br /> �(/��} i <br /> Protect Name �`�Jt / _ _ WellNo ✓r'Z� Date ``f <br /> Project No Personnel rlls <br /> GAUGING DATA Tl <br /> Water Level Measuring Method li;�/^ Measuring Point Description 70 G <br /> Casing Total Req'd <br /> WELL Total Depth Depth to Water Water Column Multiplierfor Volume PurgeVoiume <br /> VOLUME (feet) _ (feet) (feet) X Casing Diameter (gal} _ (gal) <br /> CALCULATION <br /> c� 2 .� 6 <br /> �� '�- C� 0 16 0 64 i 44 �1 •�S l� C05, Cir <br /> PURGING DATA <br /> Purge Method Y�GvV t r t C Purge Depth S c.CE:7`J Purge Rate <br /> Time <br /> ,Volume Purges(gal) - � R r <br /> -Temperature^(°C) U <br /> >" _ 1, <br /> � <br /> N.J <br /> :..�SpectflcConductivtiy(umhos)�_` _y qC) (0 q -),Q <br /> �Turbidrty/Color �L( <br /> �Ddor�� <br /> t'jv ti 7 —LIv <br /> Casing Volumes Removed . <br /> _r Devvatered�: = -- r ;••p <br /> /NJ <br /> /TJ to'L7 h I,l <br /> i <br /> Comments/Observations <br /> SAMPLING DATA Time Sampled _ Approx Depth to Water During Sampling 7 <br /> Comments <br /> _ Volume shipped Under Chain - <br /> Sample Number of Container Filled- of Custody at 4 o Analyses ti w- <br /> Number Containers - Type Preservative mL or L Turbidity Calor IN Method tr Commentsw. <br /> I/QG� �1G1 �Ur, L C V <br /> Total Purge Vol umeCP <br /> Disposal/Containment Method <br /> atherConditions <br /> ndttionofWell Box and Casing atTime ofSampling 44c3- d rG _ <br /> Well Head Conditions Requiring Correction(locks,damaged casing or well box etc) 2. Q <br /> Problems Encountered During Purging and Sampling —t%JS1 <br /> Comments <br /> PM5 PRQJ TFjVP FORMS PV9,Gi=s096 <br />