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' GROUNDWATER PURGE AND SAMPLE FORM <br /> ProlectName C�xbN „----•.,_,._.._..__._ Well No W 1 Date <br /> ProlectNo S"/S �� �� . / �C��� Personnel .e/S (i' LZ <br /> GAUGING DATA <br /> Water Level Measuring Method Measuring Point Description 1 <br />' I Casing If TotalReq'd <br /> WELL Total Depth Depth to Water Water Column Multiplierfor Volume Purge Volume <br /> VOLUME (feet) (test) (feet) X Casing Diameter <br /> CALCULATION [[ <br /> 0 16 10 64 11 44 <br /> PURGING DATA <br />' Purge Method S/FC'u21 Purge Depth Purge Rate <br /> Volume Purges(gal) <br /> ,;Ternperatur`e(°C}:�;w; -"� - r. I- v �20 a O g <br /> p pH <br /> Spec F Conductivity(m <br /> — yA �~z I L7 LT <br /> TurbiidltylColor y-' fur r_ Ccaa�r' C r4 G <br /> *Odor � ,";ip P-1 v_ rn', rY V <br /> ;^Casing VolumesRemoved 1U / <br /> a Dewatered =~2' H . ry <br /> ati_ y$:, - 1�-- I /\) I A/ -4 <br /> Comments/Observations <br /> SAMPLING DATA Time Sampled _ l _ Approx Depth to Water During Sampling <br /> Comments <br /> VoWrn Shipped Under Chain <br /> Sample Number of Container Filled of Custody at 40C Analysis <br /> Number Containers Type Preservauve (mL or L Turbidity Calor Method Cgmments <br /> l (IVDA HCL I mL -fraca, I Cc�u 9 nrr� <br /> I <br /> latalPurge Volume 5 6:�t-c1�N� DisposaVContainmentMethcd _TRAiC EP 'moi RUf`lkLc.._ <br /> /eatherConditions — <br /> Condition of Well Box and Casing at Time of Sampling _ 0(c—' <br /> Well Head Conditions Requiring Correction(locks,damaged casing orweil box,etc) <br /> Problems Encountered During Purging and Sampling <br /> Comments <br /> PM&PFO.i.TID+P FORMS,PURGE 1096 <br />