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' GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name CxXb WellNo W�y Date <br />' Project No S/53�1 �`-�'- • / 3y0 Personnel <br />' GAUGING DATA <br /> Water Level Measuring Method /,`/TrfZF�1r� Measuring Point DescriptionC:G <br />' Casing Total Req'd <br /> WELL Total Depth I Depth to Vklater I Water ColumJ�21610 <br /> Multlpllerfor Volume Purge Volume <br /> VOLUME (feet) (feet) (feet) Casing Diameter (gal)CALCULATION64 11 44 <br /> PURGING DATA <br /> Purge Method Ai Gu Purge Depth sCE"/V Purge Rate <br /> Tune-! _ �-' _u �r�r --I �`!z`7 �f ¢ rl <br /> Volume Purges(gal) �y /��] <br /> emperatur`e(°Cj,14f -` - o�3 <br /> 17,77 <br /> Specific Conductivity <br /> `Y1;r ldttyIColor�,FN <br /> ,_ -u s t <br /> -Odor :a r; r , <br /> Casing Vo[umesRemovedr� =mks ! I <br /> =Dewater`ed � <br /> Comments/Observations <br /> SAMPLINGDATA Time Sampled �� Approx Depth to Water During Sampling <br /> Comments <br /> Volume Shipped Under Cham _ <br /> Sample Number ar Container Filled at Custody at 4°C Analysis <br /> Number Containers Type Preservative {m!_or Ll Turtudrty Color M1 I Method Comments <br /> Wotal Purge Volume bAt t-VNO Disposal/Containment Method Tit L e T� t c- <br /> eatherConditions Sy��� _ _., <br /> I Condition of Well Box and Casing at Time of Sampling a le:— <br /> Well Head Conditions Requiring Correction(locks,dama ed casing orwell box,etc)LI <br /> Problems Encountered During Purging and Sampling JXJ <br /> Comments <br /> PW PRoITFUMP Fors Pelr+ee+o% <br />