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lit r r <br /> Purize Loa Form <br /> P ert Name 1 Project Number V-1—6 Site Location <br /> e 1 Na Date Field Tech p f <br /> Total Depth Depth to water 0r Water Column Length /2 13 <br /> Casing Diameter Casale Factor 1 ` <br /> Volume Calculation- �- <br /> Tow Purge Volume 6 S Casine volumes Produced r Pump Type <br /> PH Meter Calibrated CY1or N Cond Meter (4�4-., Calibrated Wor N <br /> TempNfeter Turbidity Meter <br /> Calibrated Y or N <br /> [Casing Factor 2"= 17 3"=38 4"=66 5"=1 02 6"=1 5 8"=2 6 (In Gallons per linear foot)] <br /> Time =prod Rate2-�EGallons(t6taI) II DTA'= Ph ii Ec===Te*nD("C)==Turbidity==Comments <br /> a Or -3 33,- I ag o o <br /> 11� fCO) <br /> 1 Y ! 13 r- i 1J- l a.-4 I a o 6a43I -) 13 <br /> Storage or Disposal Method -r-T - Total Drums Onsite r <br />'c-c---it Rechar4e Pnor to Sampling Sample CoIlecuon Method <br />,ample Labeled—J:z L A y✓ Sample Time Laboratory a-4= <br /> knalrsis a � - 0cA Uy GNo of Containers y <br />)uplicate Trip Blank Rsnsate Blank <br /> ocnme'lt_s Yl C.t cs►^ f U <br />