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Purge Loa, Form <br /> _ Jccis�Y _ <br /> Project Number - Site Location <br /> Qroaectl~ame <br /> Well No Date 0 p? ��� Field Tech A <br /> W <br /> Total De th 3 p y2- Depth to tiiater �-� ��' Water Colur;,n Length ��' <br /> ��• <br /> P <br /> } VolumeCalculatton 3• � <br /> Casing Diameter :2-- Casing g Factor <br /> Total Purge Volume U`v Casing volumes Produced 3i Pump Type <br /> PH Meter <br /> G'lAPIA" Calibrated by or N Cond Meter'__ _1' Cahbrated(Dor N <br /> Temp Meter- Turbidity Meter Cahbratr r N <br /> [Casing Factor, 2 17 3"=.33 4"= 66 5"=l 02 6"=1 5 8"=2 6 (In Gallons per linear foot)] <br /> Time Prod Rate GaIlons(total) DTW PhEc Temp(°C) <br /> TUrm Jry Cor,-tments <br /> I a t 3, <br /> f V- .101 1-1-9 I <br /> SLorage or Disposal ylethod' <br /> Total Drums 4asite =O <br /> Sample Collection Method-, <br /> i ercent Recharge Prior to Samplir° r = . <br /> Sample Labeled W �=W Mw " Sample Time J T D Laboratory <br /> Analysts B#�� Ez <br /> No of Containers- <br /> Duoiicate- Trip Blank Rinsate Blank <br /> Co:"nments <br />