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ETIC ENGINEERING GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name. C Well No` V�/&01 ,4 ate <br /> ProlectNo (AP39 , I _ _ Personnel. t� <br /> GAUGING DATA <br /> Water Level Measunng Method Measuring PotntDescnption- <br /> Casing Total Req'd <br /> WELL Total Depth Depth to Water — Water Column Multiptierfor Volume Purge Volume <br /> VOLUME {feet) (feet) (feet) X Casing Diameter (gal) (gal) <br /> �. <br /> CALCULATION f�k� t�I jr � 4 6 ,r <br /> �f ( 0 16 0 64 1 44 <br /> PURGING DATA <br /> Purge Method Purge Depth Purge Rate rn' <br /> ITime 4 n_'�s 112!A <br /> Volume Purges(gal). <br /> Temperature Cy-1,s n4 <br /> I y�f ��/ 5 v GA <br /> f� <br /> Specific Conductivity(umbos) r a t l< ( 4 qi q <br /> Turbidity/Color � v�YJ r,( �( �4iaj <br /> r <br /> Odor <br /> ..�Casing Volumes Rernoved��'�'=� U � � 0 -5 <br />' Dewatered? r3 ` f`✓ �` t <br /> Comments/Observations <br /> SAMPLING DATA Time Sampled ' Approx.Depth to Water During Sampling . 1-7 <br /> Comments <br /> I Volume r u Shipped Under Chain <br /> Sample Number of Container Filled o(Custody at 4°C :A�fysis <br /> Number Containers Type Preservative mL or L Turbidity Color { 1N Method Comments <br /> Total Purge Volume t QaqTr6 Disposal/Containment Method <br /> Weather Conditions v <br /> Condition of Well Box and Casing at Time of Sampling <br /> Weil Head Conditions Requiring Correction(locks,damaged casing orwell box,etc) d <br /> Problems Encountered During Purging and Sampling N <br /> Comments _ <br />