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IEDS <br /> GROUNDWATER PURGE AND SAMPLE FORM Date <br /> Protect Name Well Number <br /> rolect Number �' Q Personnel <br /> GAUGING DATA <br /> Water Level Measuruiq Metthod <br /> 1�(?Z3QL' Meaburing Pocnt Descnptfon <br /> jTot(d10e:pih Depth To Water Water Cotumro Mudiplier For Cas"'gTotal I�egd <br /> WELL Volumet <br /> e Volume <br /> VOLUM!` {te©t} (feet} Casing Diameter9�.. �,/ (gal} (gallCALCULATION0 ��• X2 4 6 <br /> V�, C(>C -0 0 i s 1 44 r 3 � <br /> PURGING DATA <br /> Purge Method Purge Depth Purge fate <br /> Tarte I t to l L Os <br /> 'VaiumePt�ijed�gaf}'Y>` = d I O <br /> Tempeiature Z 3 <br /> PH <br /> t;tfk? <br /> .t'r�^^or' Y,..V4 r!r.w�rrrw4„Sh,•^v'iyn.r f <br /> � 5rtlUtt�PS. <br /> J c,i�144v{3„ i4�vv-i.i'�3Yvv wi Zvi" <br /> r 4 3~ •v3r'r"A4/y�"hC f t.{Y3 `� <br /> umments/Observations. <br /> MPLING DATA <br /> Time Sampled. L l Approx. Depth to Water During Sampling: <br /> Comments: <br /> `"5� � f^hw�:�(�'r� cy x�pR,,v ��t� �'-- p��r,.�{ ,f�,a„'�#fib.. y YW � _ ��...��.• <br /> .-m �RO¢.ai>Yrh"<SY• 4�}�� Y 'Y��. rr4..2Csv��Yet'+ 'i"%Fda4'���41••q{.' <br /> 3I:,_ iot'a �`wff'+,N xti yv 3 w^iv a'c ;ry <br /> .ds i�, �� wtx, vc'¢ #"yo�'�a• �c 3���rrcr�` s 'vY'�tfhiF"xYx �"^�a <br /> �1�3'f��}�r <br /> ,Y <br /> I Purge Volume. G D 4cr-4 Dtsposal/Containment Method: <br /> they Conditions- <br /> n of Well Box and Casing at Tiara of Sampltng- <br /> ead Conditions Requinng Correction(lades,damaged casing or Welt box.etc.): I-k <br /> rr:s Encountered During Purging and Sampltng- <br />)mments: <br />