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Date <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name Well Number/W,41�� <br /> roject Number 5����_�7� / 340 Personnel <br /> 1 GAUGING DATA <br />' Water Level Measuring Method-Zg t/ dh -e_ Measuring Pont Description — <br /> Casing Total Req d <br /> WELL 1(feet) <br /> Depth Depth to Water Water Column Multiplier for Volume Purge Volume <br /> VOLUME (feet) — f (feet) X Casing Diameter (gal) _ (gal) <br /> CALCULATION // Z 4 I 6e7 1/ <br /> 33E7 � �CfJ ( 0181 841 44 / �O 2 SQ ' � <br /> PURGING DATA <br /> Purge Method /–f!/�I �' L� Purge Depth, Purge RateS9p <br /> Time 6 yo <br /> rVolume Purges (gal) I O -5 <br /> Temperature (OC) Z j ' - �V <br /> r pH 17I <br /> Specific Conductivity (umhos) �35-� 1 3Yz /3s� j 3 c <br /> Turbidity I Color O �4W 10l+- <br /> CG 2 <br /> Odor D I ISG i <br /> r Casing Volumes Removed r Z <br /> 6 <br /> Dewatered? <br /> Comments / Observations <br /> SAMPLING DATA3g <br /> Time Sampled �2/ Approx Depth to Water During Sampling <br /> Comments <br /> Volume Shipped Under Chain Of Analysis <br /> Sample Number of Canta�ner Custw Method Comments <br /> Numoer Containers Type Preservative mL1 r} TuMidlty color et OC YlN1 <br /> k I 1 I I I I l <br /> I I I I i 1 <br /> Total Purge Volume • c✓ DisposallContainment Method <br /> eather Conditions <br /> Condition of Well Sox and Casing at Time of Sampfing G- <br /> Well Head Conditions Requiring Correction (locks, dams ed casing or well box etc } <br /> Problems Enc un ed During Purging and Sampling <br /> Comments <br /> PMA PROJ TRAP PURGE1294 <br />