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GROUNDWATER PURGE AND SAMPLE FORM <br /> F. P <br /> 7ct <br /> ame _ C'(� WeflNo '�''tvl � Date <br /> o J5 / a31? �2 3cvQ Personnel <br /> GAUGING DATA <br /> Water Level Measuring Method Measuring Point Description 7—C <br /> WELL Total Depth Depth to Water Water Column Masing Total Reqd <br /> ultipliaftor VColume I I Purge Volume <br /> VOLUME (feet) (feet) (feet) Casino Diameter <br /> .. _ X (gal) (oaf] <br /> CALCULATION 2 o <br /> 016064 1144 / 5` <br /> I <br /> PURGING DATA <br /> Purge Method VAC4-t1-0-1) i�C-C�K Purge Depth sC4?-ce50V Purge Pate <br /> Tine=_= <br /> Volume Purges(gal) <br />' 'Temperature CO C) . v j p L� I 1 <br /> pH 2 <br /> LESpecrficConductivity{umhos)- _ C�-7q I q I -7(,R ( �� <br /> Turbidity/Color <br /> -=Casing Volumes(Removed` = oL <br /> Dewatered� rSw_ `- — -~ <br /> Comments/Observations <br /> SAMPLING DATA <br /> Time Sampled !v A ^ <br /> p pprox Depth to Water During Sampling <br /> Comments <br /> Volume Shipped under Chain <br /> Sample Numb er of Cantarnar gilled of Custody at a°C Analysis <br /> Number Containers Type Preservative mL or L} Turbidi,y Color ry/Nl I Method I Comments <br /> �r I J\IDA I he - [-{ornL Ccrt.r I ��LF-r!I `� rig IME1 <br /> Adii? <br /> tal Purge volume 6. &PLL-On45 Disposal/ContalnmentMethod TP-7P7-0 R—o&cLC- <br /> atherConditions <br /> ondt4on of Well Boxand Casing a Time of Sampling <br /> Well Head Conditions Requiring Correction(locks damaged casing or well box etc ) MJ <br /> Problems Encountered During Purging and Sampling <br /> Comments <br /> PMS PR0J TEMP FORMS PURGEIQ9G <br />