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' GROUNDWATER PURGE AND SAMPLE FORM <br /> ProlectName CXb Well No Date -�(" <br />' Protect No S/S3� 5=."�. - / 3U�� Personnel CHIP-15 CK4%Cc"'_RN <br />' GAUGING DATA <br /> Water Level Measuring Method Measuring Point Descr ption <br />' Casing Total Req d <br /> WELL Total Depth Depth to Water I I Water Column Multiplierfor Volume Purge Volume <br /> VOLUME (feet) (feet) (feet) X Casing Diameter (gal) (gal) <br /> CALCULATION <br /> 4�1' " l I 4` 0 16 10641144 <br />' PURGING DATA <br /> Purge Methody C-"L-r`/t iz'L'6c� �_ Purge Depth SCR-F--OV Purge Rate <br /> Tiirtezy�- -- cl'c'�I 33 3� <br /> Volume Purges(gal) <br /> Temperature C__) ;. � a�-� (`�/ / -2/ <br /> p" 7 7,P- 7 7 <br /> .._Specific Conductivity(r�irrthos)w*1 <br /> Turrbidtty/Co_lar�= = r <br /> s tOdc.r_f <br /> .OdorIV <br /> CasingVolumesRemoved � <br /> s Dewatered;,51. � ^" 1I <br /> Comments/Observations <br /> SAMPLING DATA Time Sampled Approx Depth to Water During Sampling <br /> Comments <br /> Volume Shipped Under Chain <br /> Sample Number of Container I Filed of Custody at 40C Analysis <br /> Number Containers Type Preservative mL a L) Turbidity Color �y Method Comments <br /> I v0A I HCL I M _ ``,-CL".. C 9 rwrEE <br /> 1 I k I I k <br /> otal Purge Volume ` ' 6f)u��� Disposal/ContainmentMethod TRA'L T-0 RD114LC- <br /> I eatherConditions <br /> Condition of Well Box and Casing atTime of Sampling <br /> Well Head Conditions Requiring Correction(locks,damaged casing orwell box,etc) <br /> Problems Encountered During Purging and Sampling <br /> IComments <br /> PMS.PRCaTEMP FORMS.PURGetag& <br />