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GROUNDWATER PURGE U GE AND SAMPLE FORM <br /> ProlectName Exxon Well No V3 Date <br /> ProlectNo 51539421300 Personnel Chris Chatburn <br /> GAUGING DATA <br /> Water Level Measuring Method Interface Probe Measuring Point Description TOC <br /> WELL Total Depth DTMO <br /> Multrpllerfor <br /> Casing Total Req'd <br />' VOLUME (feet) (feet) V(ga)a Purg`a)lume <br /> asrng DiameterCALCULATION 3990 4 6 6 064144 <br /> PURGING DATA <br /> Purge Method Vacuum Truck Purge Depth Screen Purge Rate 4 GPM <br /> Time <br /> qct <br /> gti o <br /> Volume Purges(gal), <br /> Temperature <br /> PHI <br /> 7a <br /> rte+ <br /> 0-/ <br /> 7 <br /> G <br /> Specific Conductivity(umhos) gqg <br /> Turbidity/Color-: <br /> Odor `' /2 a `j ZI-1 <br /> 1.:Y�vtYhn <br /> w Casrng Volumes Removed <br /> Dewatered'?--, 12 V YI p <br /> F Ny <br /> Comments/Observations <br /> SAMPLINGDATA Time Sampled �Ca�� <br /> p Approx Depth to Water During Sampling Feet_ l� <br /> Comments <br /> " R" volume a Shipped Under Chain <br /> Sample Number of Container of Custody at 4 C ` Y s` a <br /> Filled o Arial sis <br /> Number Containers' Type Preservative mL or L Turbidity' ~ color '�INeihod s+£ Comments <br /> < IN 'ytcr4 <br /> V3 3 Voa HCL 40 mL ��, Y MTa� BTS <br /> V3 3 Voa HCL 40 mL Y 8260 MTBE <br /> talPurgeVolume Gallons Dis osaVContainmentM Trailer to Ro <br /> P ethod mlc for disposal <br /> atherCondtrons v vi <br /> ondltionofWell Box and Casing atTime 6fSampling 45(l <br /> Well Head Conditions Requiring Correction(locks,damaged casing or well box,etc) ke <br /> Problems Encountered During Purging and Sampling n6 <br /> Comments <br /> F PROJECTS\73962%PUBLIC%SAMPLING%V3 PM5 <br />