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GROUNDWATER PURGE AND SAMPLE FORM <br />' <br /> 7Pro;ectName Well Ne Date <br /> ProjetNo <br /> Personnel <br />' GAUGING DATA <br /> Water Level Measuring Method SjE Point Desc-ption <br /> i WELL Total Depth I Depth to Water Water Column I Mufuouer.or Casing (j i atal Req d <br /> (feet) Voiume I I Durge Volume <br /> VOLUME ( {feet} (feet) X Ca�ngameter (gal) (gal) <br /> CALCULATION — 2 �J <br /> / 3 ffO6 064 1144 <br /> PURGING DATA <br /> iPurge Method V CL i�C C Purge Depth 5C1V-F0V Purge Rate <br /> Trine <br /> Volume Purges al <br />' Temperature(°C) - '_r r,i ✓�� J I L� I 2 t_J Li 2. I I <br /> pH 41, <br /> ySpectftcConductivity(Ymhos)"_'V 621 Q I I I <br /> Turbtdtty/Color <br /> Remove <br /> -�Casing VolumesRernove <br />! ;`&e,.teredl - -:4 _- <br />' Comments/Observations <br /> I <br /> I <br />' SAMPLING DATA Time A Sampled S�( <br /> P � pprox Depth to Water During Sampling 5 � <br /> Comments <br />' Volume Shipped Under Crsain <br /> Sample Number of Container t=itled o1 Custody at a'C Analysis <br /> Number Containers Type Preservative mL or Ll Turb di,y I Colot I nit I Method Comments <br /> -Yw IVDA I HGL I�f�rnL r�i� C�u•t �/ rrYs l <br /> otal Purge Volume f r bAL-L-0 N S Disposal/Containment Method ISAt LEP, T"D <br /> eatherConditions --*q'l - <br /> Condition of Well Box and Casing atTirrt of Sampling LZ- <br /> Well Head Conditions Requiring Correction(locks,damaged casing or well box etc ) ('-)X--3 >�P_ <br /> Problems Eincou-itered During Purging and Sampfing <br /> Comments <br /> PnrS PROJ T-Emp F---%Rms PUFG—c 10" <br />