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GROUNDWATER PURGE AND SAMPLE FORM <br /> ProlectName C�xd Well No pn✓V Date <br /> Project �/S�� `•=� / �U{� Personnel . QlS �c."R�/ <br /> GAUGING DATA <br /> Water Level Measuring Method /T�RFRr.'� PROEt= Measuring Point Description ?Cx' <br /> Casing Total Req'd <br /> I WELL Total Depth Depth to Water I Water Column Multiplierfor Volume Purge Volume <br /> VOLUME (feet) (fest) (feet) x CasingDtameter (gal) <br /> CALCULATION — 1 — <br /> fp <br /> ��01 6-10 64 11 44 <br /> PURGING DATA <br /> Purge Method Fi C L- n Purge Depth SCrQ�E'/V Purge Rate <br /> 1.rine ��` . .,- I�o VZI /o <br /> 1-1 <br /> Volume Purges(gal) <br /> Terriperature <br /> pFi <br /> w Spec�ic Conductivity 77 �� I <br /> HVY HVLf <br /> _�`Tur�ldtty/Color I <br /> rN <br /> Casing Volumes Removed xe o <br /> "_:': �` T - '� s�s •9��r.^:T"`.ter'; _ / _ / � <br /> LYr h Afl.T1S.. - „'�M <br /> Comments/Observations <br /> SAMPLING DATA Time Sampled .1033 Approx Depth to Water During Sampling �- f <br /> Comments <br /> Volume Shipped Under Cham <br /> Sample Number of Container Filled of Custody at a,,C Analysts <br /> Number Containers Type I Preservative mt_ar e, Turbidity Color 1tV] Method Comments <br /> PJYV 5 n VOA I HCL f rnL rr,va �Br�N tf9 rr�� <br /> i 1 <br /> irotal Purge Volume _ 12 b10'4-Uti Disposal/Containment Method IWAJ L- �t A-1_t- <br /> eatherConditions 5vN <br /> Condition of Well Box and Casing at Time of Sampling d k-- _ <br /> Well Head Conditions Requiring Correction(locks,dama_ggdcasing orwell box,etc) 62 <br /> Problems Encountered Ounng Purging and Sampling �L <br /> Comments <br /> PMS"OLTEW F°RMSPUFGeTON <br />