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Date 1 Lt,(f9 il:0_, <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> 1 Project Name C XX_c''1 _ Well Number MW <br /> Project Number 1;5 013-1 Personnel qa � Boni¢ 110 <br />' GAUGING DATA <br /> Water Level Measuring Method T„-F Measuring Point Descnntton G C- <br /> - 1{ Casing + Total Req d <br /> WELL Total Depth Depth to Water 1 Water Column I Multiplier for Volume I Purge Volume <br /> VOLUME (feet) �� (feet) (feet) Casing Diameter (gall �1 (gall <br /> CALCULATION �J Vii' �J 2 I ® 1 6 I UJ <br /> 5H gq 1 32 _I �I V73 4 0 1610 64 ' 1 44 ' I�} 23 W 1 �� <br /> PURGING DATA <br /> r1 <br /> Purge Method \lgC�m�('lIC fC Purge Depth ,fCr27gn Purge Rate 3 3 fir•+ <br /> Time 015 Z 10$.5 ! aq O 1 ! O D5 1 <br /> Volume Purges (gal) � O $ � L 1 2S 5 I J42 5 <br /> 1 Temperature (oC) I Z 1 2 I I U 121 3 2 0, q I 1 <br /> pH 114 <br /> Specific Conductivity (umhos) 79 9 %Q6 I 14 1 Cd„ <br /> Turbidity/ Calor <br /> rov✓n Cl¢CY II C�P/ g C�v <br /> 1 Odor N I N 4 t"i <br /> Casing Volumes Removed {�► 1 I 2 3 <br />' Dewatered 7 I rJ I ^/ N <br />' Comments I Observations <br /> SAMPLING DATA 5 <br /> Time Sampled o40% Approx Depth to Wale, During Sampling _3 <br />' Comments <br /> Volume Shipper]unser Cham at <br /> sarnoie Numaer of t Container I Fllea I custoc) I Analysis i <br /> Numoer Containers k Type 11 Preservative rrnt_or t1 Tu�ti'ry C <br /> ` olor at s"C jy�._ k Metnoa I comments <br /> TP' M I t o I I Hv 1 lo...� I Cko✓� I I -9 <br /> IL <br /> STotal Purge Volume 5 Disposal:Containment Method Onzr—%3 <br /> weather Conditions CG <br /> Condaton of Well Box and Casing at Time of Sampling <br /> Well Head Conditions Requiring Correction (locks damaged casing or well box etc ) r1-1 <br /> Problems Encountered During Purging and Sampling N <br /> Comments <br /> OVA FROJ TMP oURGE'23+ <br />