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�//�� GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name ._ C�xS Weil No _MgS Date/O- <br /> ProjectNo CY —'--��. L <br /> Personnel <br /> GAUGING DATA <br />' Water Level Measuring Method Measuring Point Description �d <br /> WELL Total Depth I Depth to Water Water Column Multiplierfor Casing Tctal Req'd <br />' feet f Volume Purge Volume <br /> VOLUME (feet) a (feet) (feet) X Casing Diameter (gal) _ (gal) <br /> V .X <br /> CALCULATION <br />' 0 4101 Alto> 16 0 64 1 44 <br /> PURGING DATA / <br />' Purge MethodC,U(,�t�1 `r,�(.� Purge Depth CS�'�� Purge Rate (�`�•3 <br /> �Tme45*40 4 <br /> t a+.-j v <br /> Volume Purges <br /> +'r <br /> {gal}' <br /> -" <br /> � -Temperature(.°C) _201 <br /> PH <br /> 'Z.60 S. 15C. 8`w <br /> s- ` <br /> Jl _ ctry �J <br /> ;5pectflcCondtitty(�imhos) <br /> ,x <br /> urbiditylColor;� „ce^ <br /> a No <br /> -�-Cas riig Volumes RemoveA:k�v�, Q re <br /> ':4 <br /> +4 <br />' Comments/Observations 7cr rGl(fL.. � C vz"'.e <br />' SAMPLING DATA Time Sampled D 5 <br /> P Approx Depth to Water During Sampling 3,'L <br /> Comments <br />' Volume Ch <br /> Sample Number of Container f Custody at a CAnalysis ' r <br /> Shipped Under <br /> NumbConiamFilled oaam ers Type Preservative mL or L `Turbidity Calor '-M/NJ Method Comments ^~ <br /> W C 4 I <br /> I <br /> Total Purge Volume �.�' DssposaUContainment Method -;—x? 1[Pr2 7-ei'QCh71r L' <br /> eather Conditions [ V <br /> Conditton of Well Box and Casing atTim of Sampling <br /> Well Head Conditions Requiring Correction(locks,damaged casing orwell box,etc) <br /> Problems Encountered Dunng Purging and Sampling C� <br />' Comments <br /> PM5 PROJ TEMP FCRMS PURGE1oS6 <br />