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�(GROUNDWATER PURGE AND SAMPLE F/O�R,Mn <br /> • PralectNarne _ �YJ _ _ Well No vV oma- Date_ ' 1 <br /> Project No s� �/ / /�U 0 Personnel <br />' GAUGING <br /> DATA <br /> Water Level Measuring Method 112A 0 Measuring Point Description ��G <br /> WELL Total Depth Depth to Water Water Column Multiplierfor Casing Volume Pur e Total Req'd <br />' — V� (feet) (feet) X Casing Diameter (gal) golume <br /> VOLUME (feet) (gal) <br /> CALCULATION — <br />' 016 064 144 <br /> PURGING DATA <br />' Purge Method GUVm �,. LA' - C Purge Depth _ S CC/U Purge Rate 3- r <br /> Time (o tai <br /> o <br /> Volume Purges(gal), 'K <br /> Temperati3re <br /> D9 14 <br /> C .W.S . <br />,,4�gfficConductwl <br /> '�T i�r�iditylCotoc�•'�� ��p�,,{�','�. it W `[ F- ?fv <br /> ca Ing Vorumes;7Rerrloved <br /> Comments1 Observations <br /> SAMPLING DATA Time Sam led _ � p <br /> p � �� � Apprax Depth to Water During Sampling "T T <br /> Comments <br /> - t r Volume A n a <br /> Sample Number of "Container Shipped Linder Chain <br /> Filled of Custody at 4°C Analysis . a� � '. _} <br /> Number Containers Type Preservative ''ImL or L Turbidity - Color /N Method s Comments- %r <br /> I/QC� Nom! '70r�L M , Gwr. t` 7 tt <br />' total Purge Volume Disposal/Containment Method TQ /fid <br /> PeatherCondEtions <br /> onditron of Well Boxand Casing atTme of Sampling b l� <br /> Well Head Conditions Requiring Correction(locks,dama ed casing orwell box,etc) 00 <br /> Probiems Encountered During Purging and Sampling <br /> Comments <br /> PMSPROJ TEW FORM&PURGEio96 <br />