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GROUNDWATER PURGE AND SAMPLE FORM <br />%ProjectName _9xx,r+ Well No . �nQ l Date ZI 7 <br />' Protect No 5150131 13 U d_—. . .__. _ Personnel , , v'� U <br /> GAUGING DATA <br />' Water Level Measuring MethodT-�QrFar� Pr��e Measuring Point Description 10 C <br /> Casing Total Req'd <br />' WELL Total Depth Depth to Water Water Column Multiplierfor Volume Purge Volume <br /> VOLUME (feet) (feet) (feet) X Casing Diameter (gal) (gal} <br /> CALCULATION 2 4 6 <br /> 5 4 2(a 3 2 3 5 2 f �1 t 016 0 64 744 14 OZ 4i2�.0 <br /> PURGING DATA <br /> Purge Method VaCLUrn iyVc„kPurge Depth . SC!2fg - . Purge Rate ,7,p� _ <br /> 05LI- 09 20 09.22 OG <br /> WG5n..�r`'� <br /> Voiurite Purges(gal)” <br />' T�ejmperature(o C) 1[v 3 <br /> r' n. =z�� i H 19 1 0IR 0q <br /> pectfic Conductivity(umhos)°�,,� J 1210 Z <br /> lb <br /> Turbidity/Color?r <br /> r� M fz_ <br /> N ,...� � '. kir G 14o+r C Q•r- L Q <br /> Odor <br /> -- <br /> Casing Volumes Remove"'-- 2 <br /> � <br />' Comments/Observations <br />' SAMPLING DATA Time Sampled C�°I 2 4 <br /> p Approx Depth to Water During Sampling 35 <br /> Comments <br />' Volume Shipped Under Chain <br /> Sample Number of Container Filled of Custody at 40C Analysis <br /> Number Containers Type Preservative mL or L Turbidity Color IN Method Comments <br /> ter►-9 <br /> 1Purge Volume N 2 Disposal/Containment MethodW0 <br /> therConditions zlaUJ4 <br />' Condition of Well Box and Casing at ime of Sampling <br /> Well Head Conditions Requiring Correction(locks,damaged casing orwell box,etc) rV <br /> Problems Encountered During Purging and Sampling r_1 <br /> Comments <br />' PM5PRCJTEMPF0RM$PURGEi096 <br />