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GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name Exx--�_ _ „ Well No MW I Date —(2,lea-) <br /> 1 ProjectNo 51501'Y-) 13 D n Personnel CZ <br /> GAUGING DATA <br /> Water Level Measuring Method —:rrr+>srFoca A-o- o Measuring Point Description Ta <br /> Casing Total Req'd <br /> WELL Totai Depth Depth to Wa"(fe <br /> Mukipherfor Voiume Purge Volume <br />' VOLUME (feet) (feet) Casing Diameter (gal) _ (gal} <br /> CALCULATION 4 6 <br /> , 16 064 144 15 03 H� 1 O <br /> PURGING DATA <br /> Purge Method ���vM`Tr�c-k _— Purge Depth -5C!:7�gzn Purge Rate <br /> Time C-, L`� O'b 5 O 03 5 3 o,% 15{� <br /> Volume Purges(gal) ;*y� 0 15 3 U --15 <br /> "Temperature(°C) z 21 O zd <br /> lam " ' <br /> Spectfic Conductivity(Umftos) I y5 L I~1`S 2 I 1 �1 1100 <br /> `Turbidity/Color, t 1� toY-' } ow ��--• <br /> d' or C <br /> h ;titM <br /> Odor'- <br /> tl N tJ �y N <br /> r1 h�Rt y <br /> Casing Volumes Removed+*. ,,� O 2 3 <br /> i , iV <br /> Comments/Observations <br />' SAMPLING DATA Time Sampled 6 q O O Approx Depth to Water During Sampling 33 <br /> Comments <br /> Volume Shipped Unalor Criam <br /> Sample Number of Container Filled of Custody at a°C Analysis <br /> Number Containers Type Preservauve (mL or Q Turbidity Calor Method Commenis <br /> ••J + 3 .r oo. wC l >~i��M L kap <br /> Ftal Purge Volume �-1� Disposal/Containment Method �� r <br /> eather Conditions 5tlnn <br /> Condition of Well Box and Casing atT me of Sampling O t< <br /> Well Head Conditions Requiring Correction(locks,damaged casing orwell box,etc) <br /> Problems Encountered During Purging and Sampling N <br />' Comments <br /> PMS PROJTE.Mp FORMS PURGE10% <br /> 9zi6C d Ig4M H7 Q7 S'T JrrT-17T—t1rH <br />