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a <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name �_�'xb�L\z Well No /"-1 ✓ � j/ 3 <br /> Da,e <br />' Project No SIJ �� �2 I�CJ�� Pe=rsonnel <br /> GAUGING DATA <br />' Water Level Measuring Method BEzOG2�F Measuring Pont Description 7—Cr_- <br /> WELL <br /> C:GWELL TotalDepth Depth to Water I Water Column Multiolier� Casing Total Req d <br /> Volume I ourge Volume <br /> VOLUME (feet) (feet} (feet} X Casino Diameter (gal) (gal) <br /> CALCULATION <br /> 0 16 064 � 144 <br /> PURGING DATA <br /> Purge Method V/i GL'L-c.tVYl i��_.� Purge Depth SCi4?-e-eU Purge Rata <br /> Time - - - � - ! �a�Q Iz-) ! <br />' Volume Purges(gal) <br /> tATemperatuFe(°C) <br /> Spec' <br /> Conductivity v?�v? �4, i f f <br /> NEW <br /> W w <br /> _Tutbldrty/Color <br /> Odor';= <br /> "Casing Volumes Remov_edr , _ I 1 <br /> Dewai+=red7 ,� f <br />' Comments/Observations <br />' SAMPLING DATA Time f Sampled — �L) / <br /> P .. Approx Depth to Wafer During Sampling / <br /> Comments <br />' Volume Shipped Under c`sarn <br /> Sample Number of Container Fitted of Custody at a°C Analysis <br /> Number Cantarners Type Preserva4ve mL or Ll Turbidity Golor {_� Method I Cor menu <br /> V I VDA {pct- -r-,rnL- <br /> C € yam aim <br /> Total Purge Volume Disposal/Containment Method mat C E� -r D P mkt c_. <br /> eatherCondittons <br /> ondition of Well Box and Casing atT a of Sampling A___ <br /> Well Head Conditions Requiring Correction(locks,damaged casing or well box,etc <br /> Problems Encountered During Purging and Sampling <br /> Comments <br /> PMS PRC?7 TAMP FORMS PUAGE 1095 <br />