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GROUNDWATER PURGE AND SAMPLE FORM Date <br /> Project Name 5 2-Well Number C.Z)1Q <br /> Project Number* qa Personnel ---6c— <br /> GAUGING <br /> ersonnelc— <br /> GAUGING DATA <br /> Water Level Measuring Method. C(2- PMeasuring Point Descn tion <br /> Total Depth Depth To Water Water Column -Multiplier For Casing Total Req'd <br /> WELL VOLUME (feet) (feet) ((est) Casing Diameter Volume Purge Volume <br /> CALCULATION �� � r� � � x _ (gal) (gal) <br /> o O S � � I 1 � <br /> 016 064 144 l(a �� S <br /> PURGING DATA }' <br /> Purge Method Vn� , -!Vi. C4 Purge Depth <br /> F_ ;= yi _ _._ Purge Rate <br /> WMI <br /> Time t <br /> � too OCR <br /> Volume Purged <br /> Te ^' QL <br /> .. ., .� <br /> mperature C "- --''. - <br /> - �� ' "�� aO � as � o ao 3 <br /> Boa <br /> pH <br /> Specific Conductivity ( =hos) 1110 1 ( t j p�O <br /> jiLQ— <br /> +x F�'� <br /> rbiddy/Color ...` .::-1,-rw ��` �p k0-11 <br /> Odor- <br /> Casing <br /> dorCasing Volumes Removed <br /> Dewatered7 •%""t• �,j N N <br /> Comments/Observations <br /> AMPLING DATA Time Sampled* I n IC ) <br /> P - <br /> Comments- - Approx Depth to Water During Sampling o ti <br /> San4r Niarb"o{ comalnar ,t*'� ZI , Voiarne Fded StiOP I Under Chain of <br /> Meanbar Cotia4sara Type --" t}lasarvasNa (rt1t ar TurbtdryJ Cdiorat a C{y"'T &Aee,od Coffmacei <br /> HC L t�� c�car- J �rN 1�x <br /> f I <br /> tal Purge Volume 6u Ocsposal/Containment Method <br /> fer Conditions ti'1rl <br /> action of Well Box and Casing at lime of Sam—piing K <br /> ellHead Conditions Requiring Correction (locks damaged casing or well box, etc ) <br /> Problems Encountered During Purging and Sampling <br />�mments <br />