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r <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> ProlectName G�Kd Well No di/t,iry� Date Zro <br /> Pro�ectNo S"�S 3� �2 • 1300) Personnel C(�r5 CHr~''C3c/ifE/�l <br /> GAUGING DATA <br /> Water Level Measuring Method Measuring Point Description �C <br /> CasingALP <br /> Total Req'd <br /> WELL Total Depth Depth to Water Water Column Multiplierfor Volumeurge Volume <br /> VOLUME (feet} i>~ {feet} {fest} X Casing@i�meter (gal) (gal) <br /> CALCULATION <br /> 0 161064 � <br /> PURGING DATA <br /> Purge Method V4CL.t.Lj-yyl r 'tC�,g Purge Depth SCR-e-GV Purge Rate 41" <br /> Z223 f22 I IZ2`7 I �Z-Z Cd i <br /> Volume Purges(gal) <br /> "Temperature <br /> pH <br /> Affili ----So ic Condtscttvity(uvm sjtu a �( �' I �5 Z gJ tri I <br /> -`��' --ter=��� Ytic� H,I}• tiv�{ 19v <br /> w7urbidity/Color <br /> J N/ <br /> Odor Nf <br /> Castrsg Voiume'sRemoved <br /> Qewatered� f V f v <br /> Comments/Observattons <br /> SAMPLING DATA <br /> Time Sampled I �3U Approx Depth to Water During Sampling '2 D 57/ <br /> Comments <br /> I Volume Shipped Under Chain <br /> Sample Number of Container Filled of Custody at aoC Analysts <br /> Number Containers Type Preservative fmL or LY Turbidity Color N/N Method Comments <br /> kV VOA HCL mL rr ca rig frtTr�- <br /> AlK <br /> otalPurgeVolume 1422 &ALI-ONS Dlsposal/ContalnmentMethod -r)Q-AEtL, TTL?f4t-C=�_ <br /> eather Conditions e' Y ' <br /> Cr`r <br /> Condition of Well Box and Casing at Time of Sampling O _ <br /> Well Head Conditions Requiring Correction(locks,dams ed casing orwell box,etc) <br /> Problems Encountered During Purging and Sampling _ __ <br /> Comments <br /> aM50FICITEtiwFQ m&pUFiGEj0" <br />