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I <br /> � �Z-2 Z <br /> GROUNDWATER PURGE AND SAMPLE FORM Date <br /> ProlectN4j,nrto, Well Number I <br /> 1 Project Number sz��a7-;Lq Samplers. ACL ;Z01 ,.n <br /> An 1116 <br /> AUGING DATA <br /> Water Level Measuring Method; r 55�-Measuring Point Descnption:._P-'�v • • _ <br />' Casing Total Req'd <br /> WELL Total Depth Depth to Water Water Column Multiplier for Casing Volume Purge <br /> (feet) (feet) (feet) Diameter (gal) Volume(gal) <br /> VOLUME _ <br /> CALCULATION �_ �_ X 2 4 s / 7Z `5- <br />' fl 16 064 144 <br /> PURGING DATA <br /> Purge Method PA,'\Jo 51'c� Purge Depth: Purge Rate <br /> Time ��z //31-5- //3' l y� <br />' Volume Purged(gal) Z f 5 <br /> Temperature <br /> p <br />' -Specific.ConductMty (fmhas) 90 q0 <br /> ATVeIdLty X C6lor Y' s.<; t`� Gf$� Gey Gov G,ey <br /> }Casing / <br />' }Dewatered7`(`fIN) <br /> Comments/Observations <br /> SAMPLING DATA <br />' Time Sampled: � Depth Sampled Approx Well Recovery <br /> n -Volume Shipped Under Anaiysis <br /> Sample IVumbertf.ContaTtier Fifed Chain of Custody Method <br />' Number Container ;( a Preservative { orl) <br /> Turbidity , Color at{4'C{`l1fV) lits7eibod) Comments <br /> `J UC6 #G L uv t <br />' Total Purge Volume Disposal/ContaLnment 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) ev <br /> Problems encountered During Purging and Sampling «� <br /> Comments <br />