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GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name G�xb Well No _V.a Date <br /> Project Na S-/S�� . / QUO Personnel 15 CH4 <br />' GAUGING DATA <br /> Water Level Measuring MethodR�R< Measuring Point Description <br /> Casing Total Req'd <br /> WELL Total Depth I Depth to Water Water Column f Multiplierfor Volume Purge Volume <br /> VOLUME (feet) ' (feet) (feet) X Casing Dtameter (gal) (gal) <br /> CALCULATION <br /> 0161064 f1 44 <br /> PURGING DATA <br /> Purge Method VAC-LAL LV)1/ i c ci�C Purge Depth S'CR �/V Purge Rate <br /> Time <br /> Volume Pu ges(gal) ,- <br /> "Temp attire(°C)" 4:,_"_ <br /> pH-- f - <br /> - -7 9� 7 5 7 4� 74-5 <br /> I <br /> S ecifsc Conductivity(umhos) �(g� Cf �7? 77/ <br /> t�rbidtty/Color::� ;;��; Q! �z Y�c <br /> - -s•-� " Cmc� <br /> Rk <br /> 'n"y Q�-73y"'s 7 1 <br /> sur es Remo�edj6 <br /> x';w-"a ! I <br /> Ca <br /> sin Volumi '� t <br /> Comments/Observations <br /> SAMPLING DATA Time Sampled /�� Approx Depth to Water During Sampling cZ� <br /> Comments <br /> F--Tyt'p'-'.,' <br /> Vlume Shipped Under Chain <br /> Sample Number of erFilled - of Custody at a°C Analysis <br /> Number Containers Preservauve (mL or L) Turbidity Color M1 Method Comments <br /> c� ^ �VDA HCL_ f rnL. tract C{ta�r9 `� <br /> Wetal Purge Volume bR�-t-vl�s5 Disposal/Containment Method �A1L e 7— <br /> eatherConditions S <br /> E Condition of Well Box and Casing atTime of Sampling 0 < <br /> Well Head Conditions Requiring Correction(locks,damaged casing orwell box,etc) <br /> Problems Encountered Dunng Purging and Sampling J,C <br /> Comments <br /> PW PRWTSAP FCAMIPUPGEION <br />