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TER PURGE AND SAMPLE FORM <br /> M i <br /> Well Num_e <br /> Prol�ct Name <br /> �-� <br /> (� P�-scn 1=f <br /> Proles. Vt:m�e- <br /> i <br /> GAUGING DATA <br />' Wa'-r Level measuring �tilernod Measuring Rom: Desc:tCtiorl <br /> Casing I oral meq d <br /> Total Depth Depth to'Nater �` `Nater Column i ,4Mui,sC[ter fir Volume ion-r'y'- Volt,-^e <br /> {fear} f"I {'ser) - 1 Casing Deareter (gall (3x11 <br /> VOLUI — (leaf} X <br /> CAL1U1Tl1N <br /> 70 1 Z / .5�� i a 1,3 I a 64, ' 14 <br /> [PFGING DATA <br />' Purge Method L Purge Depth Purge Rats <br /> Time <br /> Volume Purges (gal) Q . /A <br /> Temperature (°C} I Z l Z I Z / 2 <br /> pH I � � <br /> Specdtc Conductivity(-mhos) ��d Jr�D gcf� g'gs <br /> TurbtdttyI Color GO YS110 GlIZ Lv GLT L <br /> Odor ,LT A L T 1 ,17 hk-- I L-rff <br /> Casing Volumes Removed 1 z 1 13 I <br /> Dewatered'� I-t0 k <br />' Comments / Observations <br />' SAMPLING DATA1 <br /> Time Sampled �� ZD Approx. Depth to Waler During Samolfng Z <br />' Comments. <br /> volume I smloveC Ur4er Cain of xna"4 <br /> samote Numoer of eonta,ner Fite 1 Czw Cust=y Memod <br /> Numner I Csr�ta,ners I Type I Ptesenranve rmt nr t l Tur�'C+N 4 at; f'��Vi <br /> i i p � i i i cG►� i i <br /> � f <br /> Purge Total .c DtsposatfConiatnment Me,hod <br /> .. Vglume <br /> Weather Conditions <br /> Condition of Well Box and Casing at Time of Sampling <br /> 1:214-- <br /> Well Head Conditions Requiring Correction (locks darnaged casing or well box etc ) <br />' Problems Encountered During Purging and Sampling <br /> Comments <br /> e...4 anoJ r%sa au13Gfi�2�+ <br />