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a <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name c�XbN WeflNo _LI-, ) Date -2- ^= � <br />' ProlectNa Personnel C /QIS <br /> GAUGING DATA <br />' Water Level Measuring Method Measuring Point Desc,totlon i Com' <br /> Casing I i ota!Req d <br /> ter Column tvlulticiterfor <br /> WELL Total Depth Depth to Water I WaVolume Purge Volume <br /> VOLUME <br /> (feet) (feet) (feet) X Casing Diameter {g {cal) <br /> CALCULATION — al) <br /> Nl 0161064 11 44 <br /> 1 <br /> PURGING DATA <br /> Purge Method yAl GLt-U.yY? i s tt K Purge Depth SC1?_6_0y Purge Rate -7-73 _ �{ <br /> 61 Is <br />' Volume�Purges(gal) 7- 4 <br /> I <br /> nTemperature(° <br /> _Specific Conductivity <br /> x Turbrdrty/Calor <br /> C <br /> _ <br /> Odor," <br /> �Casrng Volumes Removed y L <br />' -~Dewatered� <br />' Comments/observations <br />' SAMPLINGDATA �� / <br /> Time Sampled Approx Depth to Water During Sampling l <br /> Comments <br />' <br /> Sample Number of Gontarner Volume $hipped Under Chain <br /> Analysis <br /> Firled of Custody at a°G <br /> Number Containers Type Preservauve mL or Ll Turbidity Color rY/N I Method Corimen,s <br /> � lv0A I HCL 1-turn,` i` !� e 011 jj y rg MFlJ <br /> I`)C �_ `r")+^, <br /> Total Purge Volume &PI-r-ON S DisposaVContarnment Method TAA-LE -D R_QM-t c_ <br /> eather Conditions <br /> ondltion of Well Box and Casing attime of Sampling �7 �— <br /> Well Head Conditions Requiring Correction(locks,damaged casing or well box etc) PIZ-,> <br /> Problems Encountered During Purging and Sampling _ <br /> Comments - <br /> PM5 PRnJ TEMP FORms p pZee1C% <br />