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GROUNDWATERDate <br /> PURGE AND SAMPLE FORM <br /> [:Project Name �� Well Number +fWoject Number 19 3 • 2 0 Z&, Personnel <br /> GAUGING DATA <br /> Water Level Measuring Method w K �, �,zj�L . Measuring Point Description <br />' Total Depth Depth To Water Water Column Multiplier For Casing Total Req d <br /> WELL (feet) (feet) (feet) Casing Diameter Volume Purge Volume <br /> VOLUME M.. V (gal) {gal) <br /> CALCULATION X 2 4 6 <br />' �;� �� 31- xY 1Z • 3� ops osa , � � � <br /> PURGING DATA <br />' Purge Method (Q+. yt"'Ce' -rd-nit- � Purge Depth <br /> Purge Rate <br /> TlMe <br /> VaJume,Pur <br /> p14- <br /> 'Speak 0611d It ti-vity(�Mt=) <br /> TEtI'�7l�r�r fCalQf• r � f <br /> Cast`rlb,viakieni�s Removed `{ <br /> Dew teired? j <br />' Comments/Observations fi ,2 > poK <br /> C- <br />' SAMPLING DATA Time Sam led l � <br /> p Approx Depth to Water During Sampling �6 <br /> Comments <br />' Sample fRui wt of Cckwner vertu-re FSiea odor Ch Wo of <br /> O=berinners hype F'reservsove CUStody Artaiysts <br /> # or ip �"umiany Color ur a'C jYIN� Wtho[t'' ir«rg�erFts <br /> LA'n-s 1 � u 1�w C (f <br /> Total Purge Volume We55-4 8 Disposal/Containment Method c� <br /> uGr ather Conditions L` <br /> ditron of Well Box and Casing t Time of Sampling a <br /> It Head Conditions Requiring Correction (locks,damaged casing or well box, etc) <br /> roblems Encountered During Purging and Sampling <br /> Comments 110IA <br />