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� Z <br /> GROUNDWATER PURGE AND SAMPLE FORM Date <br /> Project-rll _ Well Number: /-/(J/ a <br /> sr. �7. � Samplers:191 --d 1 <br /> Project Number: ar�lh <br /> AUGING DATA <br /> Water Leve! Measuring Method7wrr.2se�ti Measuring Point Description <br />' Casing Total Req'd <br /> WELL Tot4DepthDepth to Water Water Co[i�mn Mu[tiplter for Casing Volume Purge <br /> (feet) (feet) Diameter (gal) Volume {gal} <br /> VOLUME — <br /> CALCULATION r — l x 2 4 s — � r� �✓o CJ <br /> 0 16 64 144 <br />' PURGING DATA <br /> Purge Method. Purge Depth ccs Purge Rate <br />' Time <br /> Volume Purged(gal) r: <br />' Temperature s°�G7 7`�',_� 7''_ j � Z. Z <br /> p14 7� 0 <br />' .Specific Conductivity Mhos 'L; '0 '2�00 SOd 0600 <br /> Turbidity -4 `C6loi- � L �cY !a` � $k <br /> dark `n u;uY` _ J C �� A/0 <br /> vt" <br /> _Casing Vold rtes>Aemgyed;'t- -D rp •,Z <br /> Dewatered?s:YIN< fJ <br /> Comments/Observations <br /> SAMPLING DATA <br />' Time Sampled: S Depth Sampled.,W S:t Approx. Well Recovery <br /> x Volume Sh ppad'Under Analysts <br /> Sample NarribernE Container Filled Chair;of Custody Metttad <br /> NumberLGontainers Type Preservative (rd or 1) Turbidity Color Yat 4OC(Y/NJ (method) Comments <br /> I??(fJI.Z 3 +B <br /> Total Purge Volume Disposal/ContainmentMetbod �S <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 ), <br /> Problems encountered During Purging and Sampling W8 <br /> Comments wO <br />