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GROUNDWATER PURGE AND SAMPLE FORM Date <br /> Protect Name I,-- Well Number <br /> 6 <br /> Protect Number 37-3 Y Z C] j Personnel <br />' GAUGING DATA <br /> Water Levet Measuring Method 'k Measuring Point Description 7OC <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 y (gal) (gal) <br /> X <br /> CALCULATION i <br /> 016 064 144f `7 U <br /> PURGING DATA <br />' Purge Method lam t,4 vV"Ce- la 111— %G� Purge Depth J �+. Purge Rate <br /> Time' <br /> oturrie ttlgec goo S— <br /> n ~ t <br /> p <br /> L'~ <br />' .�7`peCt�I�"«�rG1El£�tlCt#YI��tI�Ith�S� � <br /> Turrbid }rotor v v <br /> odor <br /> -CasiV Volumes Ren oved <br />' Dewatered? <br />' Comments/Observations A) th,' L, P <br /> a <br />' SAMPLING DATA Time Sampled i� <br /> p � _ Approx Depth to Water During Sampling <br /> Comments <br /> Sample Number of CantaEner TRIed �PPod V114 F Gh$iR Dt <br /> ttriber ir�ers lTgpe/¢ Preslervxtrv�Dnafygis <br /> C�€or ai CGust 1N} AMe3hvdmerEEs <br /> Ll (,� i 1.• ((1_� 'r�"•J <br /> 1 <br /> Tota!Purge Volume Disposal/Containment Method `� - tL <br /> Weather Conditions )fit r� � <br /> onditfon of Well Box and Casing a Time of Sampling <br /> Well Head Conditions Requiring Correction (locks,damaged casing or well box, etc ) 1 <br /> Problems EncounteredDuringPurging and Sampling <br /> Comments <br /> I <br />