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GROUNDWATER PURGE AND SAMPLE FORM Date <br /> Project.- CAOO" __ _ Well Number /I/J <br /> Project Number-g4Vj27•.2 Samplers: Ak�.?92 ED 401 <br /> �AUGIING DATA <br /> Water Level Measuring Method Measuring Point Description <br /> Total Depth Depth to Water Water Column Multiplier for CCasing Total Req'd <br /> WELL p p Volume Purge <br /> VOLUME (feet) (feet) (feet) Diameter (gal) Volume (gal) <br /> CALCULATION , X 2141164 G � <br /> z �, 't - G F 2 f o 6 64, cr <br />' PURGING DATA <br /> Purge Method ✓ r Purge Depth- Purge Rate <br /> Time <br /> 'Volume Purged(gal) <br /> Temperalure <br /> PH a 9 <br /> r5. <br /> Specific Gondactivity,((onhos) <br /> •Ttirl�id�f}r � `Goior -- < r <br /> Fr i5s <br /> r k+ <br /> Casing Volurnes,ReM0V4Bd: <br />' Dewatered?&IN) <br /> Comments/Observations <br /> SAMPLING DATA <br /> Time Sampled: Depth Sampled- Approx. Well Recovery <br /> Volume Shipped Under ' Analysis <br /> nSample Numberal Contxrnur ' x filled Chain of Ctistod}� Method <br /> Number Container Type Preservative (tni ori) Turbidity Color N at 40C CYM) (method) Comments <br />' Total Purge Volume DisposallContainment Method .� <br /> Weather Conditions <br /> Condition of Well Box and Casing at Time of Sampling <br /> Well Head Conditions Requiring Correction (locks, damaged casing or well box, etc). AA? <br /> Problems encountered During Purging and Sampling;dam _. <br /> Comments <br />