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I <br /> ETIC ENGINEERING <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> ProjectName EXX-dAI WellNo ate <br /> `�O Q <br /> Pro <br /> No '�� , / ��1"l5 ��/tif� <br /> 1 Personnel: <br /> GAUGING DATA <br /> Water Level Measuring Method. I�1�Y6tCQ� �`1f 0 _ Meas unng Point Description. <br /> Casing Total Req'd <br />' WELL TotalDepth Depth to Water Water Column Multplierfor Volume PurgeVolume <br /> VOLUME (feet) (feet) (feet) X Casing Diameter (gal) _ (gal) <br /> CALCULATION _ <br /> 4 1 6 <br /> 0 1610 64 1 44 <br /> PURGING DATA <br /> Purge Method Purge Depth Purge Rate <br /> I Time - 101 ,5 ti0lb wl7 i618 <br /> Volume Purges(gal),;_- <=4 (a y 12-- <br /> p <br /> 6 Temperature(I C) C6 <br /> pH <br /> Specific Conductivity(umhos): 4-, cam 4 �•� g�� <br /> Turbidity/Color <br /> 1 J <br /> Odor <br /> Casing Volumes RemFclt ( _ JZ C) ':�i? <br /> Dewatered? ,z M1 �r P <br /> Comments/Observations <br /> SAMPLING DATA Time Sampled CrA 3 Approx Depth to Water During Sampling <br /> Comments <br /> Volume shipped Under Cham <br /> Sample Number of Container Pilled of Custody at a°C 'Z Analysis <br /> Number Containers /Type Preseemative mL or if) Turbidity Color c M Method Comments <br /> ^/ Y l./1 t4 d m L �/w V -rptiG <br /> I <br /> Total Purge Volume �2_ �( Ut(115 Disposal/ContainmentMethod �`5(1rC tC <br /> Weather Condibons v <br /> Condition of Well Box and Casing at Time of pling <br /> Well Head Conditions Requiring Correction(locks,damaged casing orwell box,etc) ( r"i <br /> Problems Encountered Dunng Purging and Sampling <br /> Comments <br />