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I <br /> GEOUS®Well Purging Form <br /> FC(0)MPANY gAMPLE NO - <br /> DATE' <br /> ThSA u 9AMPLFA. <br /> sI1� SIGNATURE. <br /> WELL OBSERVATIONS <br /> [iWE�=01:AMETER <br /> G AND LID ACT DAMAGED-MOVED-NONE LOCKED YES AC KEY NO <br />' 2' 4' 8'-8'-OTHER STICKUP HEIGHT FT-M <br /> MEASURING POINT TIC ASGRS-OTI TOC-TIC DIFFERENCE IN-CM <br /> VAPOR READINGS PID.FID DEVICE <br /> BACKGROUND hIP9 INSIDE WELL CASING <br /> NAPL LAYER OBSERVED FLT-SNK NON SAMPLED. YES-NO THICKNESS IN-CM <br /> P�ftOUR ING CALCULATIONS <br /> (A) DEPTH TO WELL BOTTOM <br /> I ' / FT-M MEASURED dgiRDED PREVIOUSL <br /> (g) DEPTH TO WATER 1^r-M TIME MEASURED <br /> (C) WATER COLUMN HEIGHT(A-B) O FT-M Weu FwWf-0 041 (Well Diameter in Inchee)2 <br /> (D) WELL DIAMETER FACTOR ■ G 5 GPF LPM (Z. W- 147, 81=261 GPF) <br /> 1 (E) ONE WELL VOLUME(C x 0) • GALL (2'-2 0, 4'-81, e' - 18.2, 8'=32.4 L phq <br /> (F) VOLUMES TO BE PURGED , „ <br /> A TOTAL.VOLUME TO BE PURGED (E x F) 9 GAL-L <br /> • URGING INFORMATION <br /> PURGING METHOD BAILERSUB PUMP- PUMP-OTHER <br /> DEVICE DESCRIPTION ui2ft <br /> I PUMP/BAILER INTAKE DEPTH TOP-BOTTOM SCR -WATER SURFACE <br /> I PURGE WATER DISCHARGED-TREATED STORED ONSITE GRED IN TAN -DRUMS NO <br /> FIELD PARAMETERS MEASURED IN <br /> FLOW THAU CHAMBER PEN CONTAINER <br /> DEPTH MEAS R1rMENTS <br /> WATER TIME TO TURBID <br /> rA COMMENTS <br />� <br /> (FT-PA j(GPFUtAFT'GEE <br /> PM-LPM) -ITM W <br /> L� 125. ISM wnl VOL <br /> :. well vol. <br /> 1Co 03I 42A 2-1.6ij <br /> sM 1 2 WeII vat. <br /> (o OrDl f 1.Z-7 i1coll a . <br /> k " <br /> MTP-Temperature MCL-Color MDO-01ssoN ed Oxygen MD1 -DTW In Well <br /> MSC-SpeWc Conductance MPH-pH MOI -Other MD2-DTW In Well <br /> MPD-PhotolonSzer(e g, HNu) MEH-Eh M02-Other M03-DTW in Well <br /> MFD-Flame Ionizer(e g, OVA) MAL-Alkalinity M03.Other MD4-OTW In Well <br /> COPYRIGHT C 1971 by Ray F Wwton Ino. G071093 <br />