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BN GROUNDWATER PURGE AND SAMPLE FORM <br /> Protect Name _ Well No lV-�ufo` Date <br /> Protect No - JU Personnel <br /> GAUGING DATA <br />' Water Level Measuring Method ��7r s� Q{� Measuring Point Description —70 G <br /> WELL Total Depth Depth to Water , Water Column Mult+plierfor Casing Tatat Req'd <br />' feet) ) (feet) X Casing Diameter Volume Purge Volume <br /> VOLUME ( (feet) ( al) (gaf) <br /> CALCULATION �. tG� <br /> 3u �� 2� 8 t�° z 6 <br /> 016 08 7 44 <br />' <br /> PURGING DATA <br />' Purge Method ✓C Guyrn Y-LA-0C Purge Depth S cCC1U <br /> Purge Rate <br /> ti Time <br />' ~` Volume Purges(ga!) � <br /> 1 -7 <br /> Temperature(0c) cip �LI rz�> <br /> ;--'Specrfic Conductivity(urnhosj `ter% Q <br /> Los <br /> - 10 <br /> Turbld�yrcoloW `a <br /> Casing Volumes Rernoved 1 <br /> Comments/Observations <br /> SAMPLING DATA Time Sampled ��� <br /> A Approx Depth to Water During Sampling T. <br /> Comments <br /> - Volumery <br /> Sample Number of Gontanor Filled Shipped Under Cram <br /> Number Containers Type Preseryauve ml-or L Turbidity Color of Custody at 4oC Analysis ` <br /> /N ,Method Comments rt <br /> Total Purge Volume Disposal/Containment Method Ta Aj d <br /> eathe r Conditions LA'r'/ti <br /> ondition of Well Box and Casing atTlmeof SamplingDL— <br /> Well Head Conditions Requiring Correction(locks,damaged casing orwell box,etc ) <br /> Problems Encountered During Purging and Sampling <br /> Comments <br /> PM5.PRQI TEMP FORM&PURGE1096 <br />