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GROUNDWATER PURGE AND SAMPLE FORM <br /> ProjectName G'�xb�V WeII No hr1 L4j (d Date h`Z6-gd_ <br /> Project No S�5 �9 `=2 3y�� Personnel CNP—tS <br /> GAUGING DATA <br /> Water Level Measuring Method Measuring Pont Description <br /> Casing Total Req d <br /> WELL Total Depth Depth to Water I Water Column Multiplierfor Volume l t Purge Volume <br /> VOLUME (feet) (feet) (feet) Casing€ iameter ( al) (gal) <br />' CALCULATION � — X g <br /> t IS � 116 � � 0 64 I 1 44 <br />' PURGING DATA <br />' Purge Method VACICL,t.m Purge Deptn SCR�6N Purge Rate <br /> Time--- <br /> Volume <br /> ime- -Volume Purges(gal) r"�, f 1-2, I 2 Ll (D I I <br /> tTemperatu>e(°C) �'" '- I Q. I 1 9 .Li I q ` > C) <br /> pH Z7 <br /> _Specrrc Gonductivrty(umbos)-1" `Ij- I CJ i 1{ 156� <br /> 7 urbtdstyl Calor I v t <br /> �CacLrulckr <br /> r Casing VolumesRemo ed`��_ _ � � � <br /> v Dewatered'? 'cam -- I" <br /> Comments/Observations <br />' SAMPLING DATA Time Sampled CH Approx Depth to Water During Sampling l <br /> Comments <br /> Volume Shipped Under Cham <br /> Sample Number o[ Container Filled of Custody at a°C Analysis <br />' Number Containers Type PresetvaWe m! or Ll Turbidity Color /N Method Comments <br /> 1D I IVDA HCL ML 11nw I CCS 9 ' <br /> i I i I I i <br /> I I I I I I <br /> otaiPurgeVolume S Otsposal/ContainmentMethod . _T7ZAtC E 7-D RUIu LC, <br /> atherConditions <br /> ondition of Well Box and Casing atTime of Sampling (� <br /> Well Head Conditions Requiring Correction(locks,damaged casing orwell box,etc ) <br /> Problems Encountered During Purging and Sampling <br /> Comments " <br />' PMS PROD TEMP FORMS pURGEtose, <br />