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' GROUNDWATER PURGE AND SAMPLE FORM <br /> Protect NametC-x-, __ Well No W � DateiZI 9-1Protect Norj 0 ti l 13 U a __ Personnel o _ <br />' GAUGING DATA <br /> Water Level Measuring Method +ar�o�c� Measuring Point Description1 O C <br /> l Depth Depth WtWater ClMflf <br />' Casing Total Req'd <br /> WELL Totaepito Water er oumn uttpieror Volume Purge Votume <br /> VOLUME (feet} _ {feet) — {feet) X Casing Diameter (gal) _ (gat) <br /> CALCULATION -33 <br /> 6 <br /> 5q l>?O 33 95 25 C05 016 464 1 1_44 1i� �iZ H9 z5 <br /> PURGING DATA <br /> Purge MethodyaCUU*- }"rilck _ Purge Depth SCre Purge Rate Z y <br /> }- ,� <br /> 0C 5Z <br /> D OG'S� a <br /> Vof6me Purges(gal) (a 5 4 33 Hq <br /> %Temperature(°C) Exn <br /> +. ,K—�`...xc•Orr ��".! s <br /> �Specdic Conductjvityy(uum�hose}!-, I yV I y 3 y 4 y y l 1 4 13;Y <br /> -�? >µ� �.r "- ksa•'v�e}a-�`r'�_`y -° <br /> ;TurbrlditylCJ,olor u x � E�Gr ! Cl�+q� CI¢c✓ <br />' <br /> C <br /> 'sing Volumes Removed=rte iV <br /> �. <br /> Dewatered? <br />' Comments/Observations <br />' SAMPLING DATA Time Sampled t Approx Depth to Water During Sampling <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 -fY!N - Method Comments <br /> ter''9 <br /> tal Purge Volume �qJr Disposal/Containment Method <br />'lWatherCondittons C o i <br /> Condition of Well Box and casing it-rime of Sampling <br /> Well Head Conditions Requiring Correction(locks damaged casing orwell box,etc) !V <br /> Problems Encountered During Purging and Sampling <br /> ' Comments <br /> PMS PROJ TEMP FORMS PURGE10% <br />