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1 <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name Well No Date O-/U! <br />' ProlectNo �51"S b/ Personnel <br /> GAUGING DATA <br />' Water Level Measuring Method �a7'�PYf'cl C�2 6�f Measuring Point Description �0 <br /> WELL Total Depth Depth to Water I Water Column Multiplierfor Casing Total Req'd <br />' feet f Volume Purge Volume <br /> VOLUME ( } rr.t (eeE) (feet) X Casing Diameter (gal) _ {gal) <br /> CALCULATION r r- <br /> 66•D2 : ^ ZZ .s P 2 4 6 <br />' 0 1610 64 <br /> PURGING DATA <br /> Purge Method —F,2-udvl Purge Depth �� �� Purge RateRPM <br /> Time , <br /> Volume Purges(gal) r =yr At <br /> ",Tempi ratur`e{°C)� <br /> : Spectflc Conductivity{umf4Z 2242- 2-12 <br /> uTurbidtty/Cnlor, �, LL <br /> 'Casing Volumes Removed" <br /> Dewatered _ (\J O N v 5N: <br /> d N <br /> -'� 3 rr <br /> Comments/Observations <br />' SAMPLING DATA Time Sampled <br /> Approx Depth to Water During Sampling <br /> Comments <br /> t Volume Shipped Under Chain <br /> FN > <br /> Sample Number of Container liledof Custody at a°C Analysis <br /> Number Containers Type Preservative ml or L Turbidity Color Method Comments - <br /> HCJ 40(-Y)i L f <br /> 1 <br /> t <br /> otal Purge Volume Disposal/Containment Method ! 'Tv�GYY1t <br /> eather Conditions onditionof Well Box and Casing atTime of Samplingell Head Conditions Requiring Correction(locks,damaged casing or well box,etc) do <br /> Problems Encountered During Purging and Sampling <br />' Comments <br /> PM5 PROD TEMP FORMS PURGE1096 <br />