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Date <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name, _ - 2219_______-_ Well Number- <br /> Project Number- e77 757-'�2- Personnel IL <br /> AUGING DATA <br /> Water Level Measunng Method• Measuring Point Description . <br /> Total Depth Depth To Water Water Column Multiplier For Casing Total Req'd <br />` WELL (feet) (feet) (feet) Casing Diameter Voiutne Purge Volume <br /> VOLUME ... _ (gal) (gal) <br /> CALCULATION q �` 2 S <br /> 3c75 ` 016 4 i 4tS ,r3 <br /> PURGING DATA <br /> Purge Method L J,���� �1 � Purge Depth s-y,--r— - - Purge Rate <br /> Time <br /> Volume Purged (gal) ry Cz -Z <br /> ti wx <br /> Temperature (°C) .` lop 1 u! <br /> 1447 !f� <br /> pH <br /> Specific Conducttvit (µmhos) Qp DD <br /> L <br /> Turbidity Color <br /> / <br /> r � <br /> C CIt+C <br /> Casing Volumes Removed - Z <br /> fDewatered? <br /> Comments/Observattons <br /> SAMPLING DATA Tine Sampled -y <br /> P .� _ Apj3rax Depth to Water During Sampling <br /> Comments <br /> Sh9ped tlnaer Chinn of <br /> Sample Nun torr of Voiune FL"d - Custody Anatym ' <br /> Number CMDArms Type (ad or 9 Tuea&ty Cow at 4'C tYrm Matno4 C fnrnoms <br /> �o lUz:_ <br /> 1 <br /> Total Purge Volume D�sposai/Conta,nment Method S <br /> IWC <br /> nC <br /> eather Conditions <br /> dition of Well Box and Casing at Time of Sampling AZ <br /> Head Conditions Requiring Correction (locks damaged casing or well box etc ) 1 <br /> roblems Enco ntered During Purging and Sampling <br /> omments - — ---- — --- --- ---- - - - <br />