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GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name CK=a Well No M Date I '1 <br />' ProjectNo 1J d 131. 1 3 O Personnel <br /> GAUGING DATA <br /> fWater Level Measuring Method /' ¢ 6-0&7 Measuring Point Description <br /> Casing Total Req'd <br /> WELL Total Depth Depth to Water Water Column Multiplier for Volume Purge Volume <br /> VOLUME (feet) (feet) (feet) Casing Diameter <br /> CALCULATION r� X (9a1) (gal) <br /> Su.q g s aq o 2 a 6 <br />' 2'�' °5 • 16 a s4 1 � 15.31 Ola.11 <br /> PURGING DATA <br /> Purge Method —Fru c k Purge Depth SCflrq,n _ Purge Rate 5-$_ !In _ <br /> Time <br /> 10- 1,4 <br /> Volur ie Purges(gal) 15 <br /> l r4 <br />' x Temperature(°C) <br /> pH ° , <br /> } Y, dti�Ycii <br /> y <br /> Z S_D5 <br /> .oca 3.Oct <br /> Specific Conductivity(umhos) <br /> «~Turbid lColor r,` .•- ` ' ]o...r 1 0%.� vw <br /> rty I a <br /> C c[ <br /> Odor - <br /> sv'4"v n _ �1 <br /> Casing Volumes Removed <br /> Dewateredl? fv <br /> Comments/Observations <br /> SAMPLING DATA Time Sampled I � Z(a <br /> p .�P Approx Depth to Water During Sampling 35 <br /> Comments <br /> Sample Number of Container Volume Shipped Under Cham <br /> Number Containers Type PreservalEve m�iio � Tumidity Color ofCusto�at4°C Mnaysi Comments <br /> - . h. <br /> 31 � r <br /> E= <br /> Total Purge Volume <br /> DisposaUContainmentMethod _tticii I¢r 1-3 Rawiti(j <br /> eatherConditlons <br /> rProblems <br /> ondiUonofWepj3oxand Casing atTime ampling <br /> ell Head Conditions Requiring Correction(locks,damaged casing orwell box,etc ) _ ry <br /> Encountered During Purging and Sampling T <br /> Comments - _ <br /> r Pso,i TEW FORM$piuraae:o9a <br />