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I <br /> ETIC ENGINEERING <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> ProlectName lte)v XQ V Well No.__y J ate v <br /> nnf'Ir�s <br /> Protect No Personnel. <br /> GAUGING DATA <br /> Water Leel Measuring Method Measuring Point Description: <br /> Casing Tota!Req'd <br /> WELL Total DepthMDepthtoWater Water Column Multipherfor Volume PurgeVolumeVOLUME (feet) (feet) Casing Diameter (gal) (gal) <br /> CALCULATION 4 6j <br /> 0 16 064 144 <br /> PURGING DATA ( ,` <br /> Purge Method Purge Depth Purge Rate Ll AVrn' <br /> Time �( Otto Ll(I <br /> Volume Purges(gal), h z��r;. [/ 44i <br /> r Temperature(°C)'-� 1 s i� �• L`-f Is- LP <br /> Specific Conductivity(u : L `� <br /> Turbidity/Color -� t LAM- <br /> Odor -- V J�✓ <br /> . <br /> v� oCasing,Volumes RemvtR=. 194 <br /> Dewatered? F17'�'= �" r <br /> r <br />' Comments/Observations <br />' SAMPLING DATA Time Sampled 61-25 _ Approx Depth to Water During Sampling <br />' Comments <br /> Volume r Shipped Under Chain <br /> Sample Number of Container Filled of Custody at 40C Analysis <br /> Number Containers Type Preservative mL or t. Turbiddy - Color Method Comments <br /> Total Purge Volume _ l [���t Disposal/ContainmentMethod <br /> WeatherCondttions 6v <br /> Condition of Well Box and Casing at Time df Sampling <br /> Well Head Cond itions Requiring Correction(locks,damaged casingorwell box,etc <br /> ) u <br />' Problems Encountered During Purging and Sampling <br /> Comments <br />