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so� GROUNDWATER PURGE AND SAMPLE FORM crate <br /> Protect Name Well Number <br /> Protect Nt�rr�bCr ,7.t1, - <br /> AFUGING DATA <br /> W,3ler Level M0.1surutq Method) ey-f G'��`t�l�d''�—�_� Me.isur�ric� t'o�r�t 13r�scr�4tUori '7-0-42— - <br /> w_ otal Req d <br /> Total DePih Depth 10 Water Water Golumn MuMpher For voluntC Purge Volume <br /> WELL (toot) (fedi) (toot) Casing Diarnoter (gat) (gay) <br /> VOLUME - <br /> CALCULATION (� �7 j 2 4 �' <br /> ��.©� l �pU 0 16 0 �l 144 . <br /> PURGING DATA <br /> Purge Method zl_-er iiG9-7 Purge Purge Rate C <br /> Y } <br /> Time d /GYJ �4D 1Dd <br /> Ya€crme Purges <br /> ZeaVeratUe(aG) <br /> y 7 ? <br /> Sgeci�ic"�dcl`ctiv ty{�cirrtxas�: f,2.� zSDD boa � <br /> TCO W <br /> 171, IV <br /> [I <br />,C 4 Y.4yr `Y <br />�mments/Observations: <br /> L <br /> �MPLING DATA "rime Sampted:.122la Approx Depth to Water During Sampling- <br /> Comments: <br /> '.Ss <br /> ieir<q��. <br /> tt <br /> y Y'v k� .... �"E '+`tea;,C—��F2 �1:��. �Y�;�v.4; }�yys�+3 S'"�ifi`� 7'kty. :k:w�'v tf�`�Vis^ ?„�sc.�� -ry�i✓3�v+,n t�s .�r`''Jr T�� <br /> z f 3�srt�-.s.,,yscy 4,�a,�w{.�C ,, art ;f#�#..,nc� 3�`iitidR![r'gE`%„'t2`l,"'d�Qt," ' s '',�• �}{.Q Ew /J��A.;�,.w' > "".1k9ho -;`s`a? ,F,..: g fc'%� <br /> Uh G L ul CL Y2 ir <br /> T . <br /> I Purge Volume yA _ _ _— Dtspos I/Cu amment Method: <br /> her Condttons- <br /> n of Weil Box and Casing at Time of Sampling: <br /> ad Conditions Requtnng Correction(locks,damaged casing or well box,etc.)- I— <br /> Encountered During Purging and Sampling. <br /> nrnents- <br /> 1 <br />