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GROUNDWATER PURGE AND SAMPLE FORM Date <br /> Project Names r.• Well Number. <br /> Project Number Q <br /> Personnel <br /> AUGING DATA <br /> Water level Measunng Method <br /> Measuring Pant Description _ <br /> Total Depth Depth To Water Water Column Casing Total Req'd <br /> WELL (feet) (feet) Multiplier For <br /> VOLUME (feet) Casing Diameter Volume Purge Volume <br /> CALCULATION = � (gal) (gal) <br /> _5o q0 Z 7 6 u <br /> 4 g <br />' 0 1 fi 4 1 44 . <br /> PURGING DATA <br /> Purge Method <br /> Purge Depth <br /> Purge Rate <br /> Time <br />' Volume Purged(gal) <br /> Z � 4 Sr• D <br /> Temperature (°C) y N N Zp Zd G ZO o <br /> pH <br />' Specific Conductivity (gmhos) 7� <br /> d0 �Q <br /> Turbidity/Color <br /> rMZr <br /> C f� <br /> Casing Volumes Removed Q i <br /> Dewatered7 <br /> eS <br /> Comments/Observations <br /> SAMPLING DATA Time Sampled �j5f <br /> Comments , Approx Depth to Water During Sampling <br /> $wpb Nunber cl Container Valums Fled Sh9ped Under Cham of <br /> NumbeContalnsre Type Preser wive Custody <br /> (rid a i) Turbidly Calor et 4'C{7rfvt Method coffw"as <br /> � r <br /> j � I <br /> Total Purge Volume .3 <br /> Bather Conditions <br /> Disposaxonta,nment Method +u <br /> / v <br /> onclition of Well Box and Casing at Time of Sampling <br /> Head Conditions Requiring Carrect,on (locks damaged casing or,,veil box etc ) <br /> Pomt)mentS <br /> iems Encountered During Purging and Sampling <br /> �� <br />