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GROUNDWATER PURGE AND SAMPLE <br /> _ FORM <br /> Protect Name _ CXb/1f Well No T , / Dat.. <br /> _ -'i-X LL, o <br /> ProjectNo s/S �� �2 • /3UQ Personnel <br /> ig LZ <br /> GAUGING DATA <br /> iWater Level Measuring Method 066�7 Measuring Point Description 7-CC <br /> WELL Total Depth t Depth to Water l Water Column Muftiplierfor Casing Total Req d <br /> Volume I Purge Volume <br /> i VOLUME (feet) (feet) (feet) X Casing Diameter (gal) _ (gal) <br /> CALCULATION <br /> �o �� t5 �2 �'� o6I 4 s 2-1 ` (Q�i. <br /> 0 64 144 <br /> PURGING DATA <br /> Purge Method VA Cf• L.tW? Purge Depth ��h�rE'1V Purge Rate —7- 7 36191 /f <br /> 1,2 f5 k �o\ � '�Q� I ! <br /> Volume Purges(gal) <br /> -TemperatuF (°O-;b' 98 y- - Q �� ��� v� I llc� '9L— <br /> -H co cb -7- <br /> Specific Canductivtty(umtios)k;' q �lQa•�- `"� a �j- <br /> Turbidity/Color -_ b u <br /> =Odor_ .a 1• � ! <br /> Casing Volumes Remove � I <br /> x�Dewatered�= <br /> Comments/Observations F <br /> r <br /> SAMPLING DATA Time Sampled o Approx Depth to Water During Sampling <br /> Comments ' <br /> i <br /> r <br /> Sample Number of Contarner Volume Shipped Under Chain - <br /> Filled of Custody at 40C Analysis <br /> Number Containers Type Preservative mL or L Turb:dity Color (YIN) Method Comments <br /> w VA HCL mL <br /> F <br /> I` r <br /> � a <br /> 1 Purge Volume [,e 6Au-ONC, Disposal/ContainmentMethod Til C. TrO RUM tcr_ ; <br /> therConddions U t1 t <br /> nddion of Well Box and Casing at Time of Sampling C- <br /> ell Head Conditions Requiring Correction(locks,dam ged casing orwell box etc) <br /> roblems Encountered During Purging and Sampling <br /> comments <br /> I'll PRQt TEMP FORMS PugGE1096 <br />