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En <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name Well No /"r✓�-� Dates '� 9 <br /> Project No Personnel <br />' GAUGING DATA <br /> Water Level Measuring Method It/T !SFA(�E Ptgp6E= Measuring Point Desc•Iptlon <br />' WELL Total Depth I Depth to Water Water Column Multloherror Cann Total Ra d <br /> Volume I I Purge Volume <br /> VOLUME= {;est) (feet) {feet} Casing Diameter <br /> � {ga€} (gal) <br /> CALCULATION — — <br /> 021 <br /> 16064 11 44I <br /> PURGING DATA <br /> Purge Method __Yfi C�yy) 7 9-C z Purge Depth SCR-e76N Purge Rate 5; <br /> Time- <br /> Ste•= Y l �f S4�' -.'r Y <br /> Volume Purges(gal) <br />' `Temperature <br /> pltl <br /> - S-3 <br /> Specrfrc Conductivity(umbos) <br /> Color-,+ h" i�T Lt ��r�t l� <br /> >rc.^ ?I <br /> L cc� I Gtlt,� IJ?txr �1 <br /> Odor---__ <br /> �Castng Vafumes f3emoved Y'..;�=_ <br /> Dewatered� -- <br />' Comments/Observations <br />' SAMPLINGDATA Time Sampled ^C <br /> p Approx Depth to Water During Sampling <br /> Comments <br /> Volume Shipped Under chain <br /> Sample Number of Container Filled of Custody at<oC Analysis <br /> Number Canlaaners Type Preservative (ml-at Q Turbidity Color f11N1 Method Comments <br /> I IV0A hct- I4ornL � o� I r' I y g sr�rl <br /> I I I I I I I I <br /> offal Purge Volume Disposal/Containment Method _ TRAt L.Eg -rDi �fu-L c- <br /> eatherCondittons ✓a" <br /> ondition of Well Box and Casing aYrirrte of Sampling _SIL- _ <br /> Well Head Conditions Requiring Correction(locks damaged casing or well box,etc ) f> <br /> Problems Encountered During Purging and Sampling /✓ <br /> Comments <br /> PMS PROJ Tr-MP FORMS PUAGelm <br />