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' Purge Lo Form <br /> g g <br /> Project Name Nam i z j `mak Protect Number q b i g 6 Site Location fIA"IL-&, <br /> PIe!l No Date O 5 i 0, 0 9�1 Field Tech 41 <br /> Total Depth Depth to water 3? s Water Column Length 3 Iz a <br /> Casing Diameter Casing Factor i Volume Calculation �`- <br /> Total Purge Volume v Casing volumes Produced 3. Pump Type <br /> PH Meter mvonil Calibrated (�)orN Cond. Meter NYA, Calibrated{ or <br /> Temp Meter 9V A" Turbidity Meter /RA Calibrated Y or N <br /> ' [Casing Factor 2"= 17 3"=38 4"=66 5"=l 02 6"=1 5 8"=2 6 (In Gallons per linear foot)] <br /> Time--_-=Prod Rate =Gallons(total) DTW - Ph - - He Tem (°C) Turbiditv Comments - -- <br /> -1\4 6 1 6rk j L b 14 Sa-o 0 3 AA (JS. .. - - <br /> �-S 6 c 3 g s r .6 -43 i T J-3 69 6 ,w <br /> ' 6 11 1541 61-7 <br /> 13.579 Is e �3 6 -+t, 69.1 1 <br /> 13 0 J 3Ts 'r-I 6 i s? L 1-1. W� <br /> Storage or Disposal Method Sf Total Drums Onsite S <br /> ' Percent Recharge Prior to Sampling ��y4. Sample Collection Methodp-cam <br /> Sample Labeled -^V/ - 1 Sample Time y y v Laboratory <br /> Analysis rx6 C) �Nar Ll <br /> _ .,_ No of Containers <br /> ' Duplicate T Trip Blank Rinsate Blank �. <br /> ' Comments <br />