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GROUNDWATER PURGE AND SAMPLE FORM <br />' Project Name c xxc'n __ Well No ___ K3 Date I I <br /> Project No 5153 q!7 Personnel 12 �a MI <br />' GAUGING DATA <br /> Water Level Measuring Method lr`r oc A_o�Q Measunng Point Description —i o <br />' Casing Tota[Req'd <br /> WELL Total Depth Qepih to Water Water Column Multiplierfor Volume Purge Volume <br /> VOLUME (feet) _ (feet) (feet) X Casing Diameter (gal) (gal) <br />' CALCULATION 4 6 <br /> 3°I �l 0 2'-I S f 5. 2 S 0 16 0 64 1144 1 <br />' PURGING DATA <br /> Purge Method Vcacuyr n -Gryr-K Purge Depth Scr¢o Purge Rate2 5 Qom+ <br />' Time 09 51 Oc� 51 0 9 Sq f o o u <br /> ,r <br />' Volume Purges <br /> Temperature(°C) 3 11 1 <br /> pH f <br /> u 1 1 53 <br /> SpecifiicConductrvity(umhas} � C&A-11 $1 �� 3 g_4 q <br /> r — <br /> `1Turf�idrt'Oolor <br /> r} ~if <br /> ,Odom r,r *L ;..�-, �� �► t C tN C H <br /> Casing Volumes Removed D ) <br /> Comments/Observations <br /> SAMPLING DATA c7 <br /> Time Sampled 10 3 Approx Depth to Water During Sampling �$ <br /> Comments 4 <br /> Sample Number of Container Volume Shipped Under C <br /> Filled of Custody at 40 <br /> hain Analysis <br /> C y <br /> Number Containers Type Preservabva mL or L Turbidity Color INMethod - Comments - <br /> kt <br /> `rPH- <br /> V v o ops HC I y 0 r.,1 I ow <br /> otal Purge Volume "-7 S Disposal/ContalnmentMethod {' <br /> WeatherConditions c t oL' <br /> Condition of Well Box and Casing atTime of Sampling i <br /> Well Head Conditions Requiring Correction(locks,damaged casing orwe I box,etc) <br /> Problems Encountered During Purging and Sampling <br /> Comments <br /> PM„5 PRCU T-EMp Fl7iiMS PZ)RC CYaF <br />