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f <br /> ETIC ENGINEERING <br /> f GROUNDWATER PURGE AND SAMPLE FORM <br /> ProlectName. C XXdA/ Well No <br /> Project No �69 , I Personnel: <br /> GAUGING DATA <br /> Water Level Measuring Method. �Cr Measuring Point Description: <br /> C�,ng Total Req'd <br /> f WELL Total Depth Depth to Water Water Column Multipherfor Ve Purge Volume <br /> VOLUME (feet) (feet) (feet) X Casing Diameter (9�) <br /> CALCULATION <br /> a q 4 016 0 64 144 <br /> f <br /> PURGING DATA <br /> fPurge Method � � _ � Purge DepthPurge Rate -7 <br /> Time <br /> Volume Purges(gal),``� .y ": <br /> f _ . <br /> ,Temperature <br /> PH <br /> Specific Conductivity(umhos) <br /> Turbtdity/Color _ tD <br /> Odor rjt <br /> Casing Volumes Removedr <br /> fDewatered? a, <br /> fComments I Observations <br /> fSAMPLING DATA Time Sampled Approx Depth to Water During Sampling. <br /> f Comments <br /> Volume i ��- Shipped Under Chain <br /> Sample Number of Container Filled �` o!Custody a140C Analysis <br /> Number Containers Type Presenralive mL or L Turtyidity Color ;Method Comments <br /> f ^� vim- Gc L10,�� <br /> f � <br /> Total Purge Volume �� Dtsposal/ContainmentMethod t �f ' <br /> Weather Conditions <br /> Condition of Well Box and Casing at Time of ISampfing <br /> Well Head Conditions Requiring Correction(locks,damaged casing or well box,etc) <br /> I Problems Encountered During Purging and Sampling Nk--�. <br /> Comments <br />