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Date ` <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> Project: Well Number: P11- <br /> Project <br /> Project Number 7- Z? _ Samplers- <br /> AUGING DATA <br /> Water Level Measuring MethodAy � Measuring Pant Descnptton:t222Q----1 <br /> Casing Total Req'd <br /> WELL <br /> Total Depth Depth to Water 6WaterColumn Multrpf3er for Casing Volume Purge <br /> (feet) (feet) X Diameter (gal) Volume (gal) <br /> VOLUME <br /> CALCULATION <br /> TO 44 <br /> 01 144 <br /> PURGING DATA <br />' Purge Method:,L--'Z::tf Purge Depth �— Purge Rate <br /> Time �� 7- j <br /> Volume Purged(gal) - <br /> Temperature(*C)- " jU Z 4!�,- <br /> Specific Cond#ictiui (G hos) V60 c t f-gQ <br />' Y Turbidl :J>'46 -"r' , y. wa - ,nt - N �� /'l-f� <br /> » _�Y �( R rev <br /> car , vrn ,nl��ft 1746 I-f <br /> r mfr <br /> Qawatered? 'i�3i ` v n< . �' �," f AJ <br /> Comments/Observations <br /> SAMPLING DATA <br /> Time Sampled: Depth Sampled Approx. Well Recovery- <br /> An Vofu a Shipped Under Ala#ysis <br /> Sample Numbero€ Contaieer >; ed ' Chain of Custody �Method <br /> Number Containers Preservative Turbidity -.Oofor at 4°C(YIN) (method) Comments <br /> Total Purge Volume Disposal/Containment Method <br /> Weather Conditions <br /> Condition of Well Box and Casing at Time of Sampling a -� <br /> Well Head Conditions Requiring Correction (locks, damaged casing or well box, etc ), <br /> Problems encountered During Purging and Sampling <br /> Comments.R � -- <br />