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Im <br /> �GROUNDWATER PURGE AND SAMPLE FORM <br /> Protect Name Well No <br /> Date <br /> Protect No �/ �l- % �(]Q <br />' � Personnel <br /> GAUGING DATA <br /> Water Level Measuring Method 1127�or Measuring Point Description <�- <br /> WELL Total Depth Depth to Water Water Column Multlpllerfor Casing Total Req'd <br /> VOLUME (feet) _ (feet) _ (feet) Casing Diameter Volume Purge Volume <br /> CALCULATION X (gal) _ (gal) <br /> �� �(o• LS 7�'�i L1� 2 r 4 6 <br />' o �s a s4 � AA DATA <br />' Pur e Method <br /> . -- Purge Depth _S CC/`,� Purge Rate ?3-7? <br /> ,me � _,w;� <br /> - VoEume PurgesXz <br /> 7FemPerature`( C)" „� � '} 44 <br /> "" �-{:ss�,`�_ •�t^�'v„E-"`•,�-r $"F"Y«:pry 8 ; <br /> V <br /> v't" 7r�zf a -raw';`Nl= u'as: &.. -• g- -7 + e <br /> ^4 l f <br /> J [ k+ <br /> 1.1 :r 4w�kry'�-mac XS.s+v YY^ <br /> S ecdic Conductivit'/umbos q-7� <br /> 7 ISR..: <br /> Tuldivy bofg <br /> Odor�Y �y 1, <br /> Casinguo{'ymes Remov / a <br /> z7Dewatered !V <br /> IV c <br /> Comments/Observations t <br />' I <br /> SAMPLING DATA Time Sampled { <br /> Approx Depth to Water During Sampling T. <br /> Comments <br /> Sample Number of Contain;n`er' Volume Shipped Under Cham m u r ^ <br /> Number containers ' T a <br /> Filled of Cusco at 4°C Analysis <br /> i YP Preservative mL or L Turbidity Color M Method Comments <br /> Ll vocx CCZZV- Q 7 <br /> otal Purge Volume _ (9 S /?�,�(��?,y DisposaVContainment Method Tp � ' <br /> therCondtbons r <br /> ition of Well Box and Casing at TimeofSampling CSK <br /> Veli Head Conditions Requiring Correction(locks,damaged casing or well box,etc) Y)u <br /> 'roblems Encountered Dunng Purging and Sampling <br /> omments <br /> IMSPR0I.TEMPFORKSPUPGE1Q96 ` <br /> I <br />