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GROUNDWATER PURGE AND SAMPLE FORM <br /> ProjectName Well No /Y1M//iJ�, Date — <br /> ProiectNo _c l' O./ ��d(� Personnel <br /> GAUGING DATA <br />' Water Level Measuring Method 407`Pr-F'62 (Q Q754f Measuring Point Description <br /> Casing' Total Req'd WELL Total Depth Depth to Water WaterCofumn Multlplierfor Volume Purge Volume <br /> VOLUME (feet) (feet) _ (feet) X Casing Diameter (gal) (gal) <br /> 59 <br /> CALCULATION 2 6 �7.11.432,11.432,� <br /> 0 16 0 64 1 1 44 <br /> PURGING DATA <br /> Purge Method VO-IA2U!m Purge Depth (SCREE) Purge Rate <br /> ��� <br /> Time r <br /> Voiume Purges(gal) q^ =�� Y <br />' n ,Temperature(°C) r `� M-y I7.S . Cjj 1 1• 1 <br /> lift ;'SpectficConducttv�ItY �r► 'Os) <br /> Turbidity/Color,,-,�. � �s � Gtr <br /> �b <br /> T <br /> K.; �t�r r-�•� ��,�tt�sA-f.�. <br /> Nip <br /> zCasing Vot me Remove v 12— <br /> o <br /> NoComments/Observations <br /> 71 <br />' SAMPLING DATA Time Sampled a•ZS Approx Depth to Water During Sampling 3 Z ' ' <br /> Comments <br /> Sample Number of Container Volume u - Shipped Under Chain Analysis, <br /> Foiled of Custody at 40C <br /> Number Containers Type Preservative mL or L Turbidity Color �N Method 1`M Comments <br />' Total Purge Volume Disposal/Containment Method Tt t Ty Gl�'it <br /> eather Conditions <br /> Condition of Well Box and Casing atTimJ of Sampling 10 <br /> Well Head Conditions Requiring Correction(locks,damaged casing orwell box,etc ) <br /> Problems Encountered During PurgingandSampling NQ <br />' Comments <br /> PM5 PRQJ TEMP FORMS PURGE 1096 <br />