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GROUNDWATER PURGE AND SAMPLE FORM <br /> n <br /> ProlectName Cxxbl�! Well No eDate <br /> ProlectN ��5 �� `'-�'- , 1 �U<� Personnel <br /> GAUGING DATA <br /> Water Level Measuring Method O - Measuring Point Description 7-01 <br /> Czsing Total Req d <br /> WELL Total Depth Depth to Water Water Column Multlp3lerfor Volume I Purge Volume <br /> VOLUME (feet) (feet) {feet) Casing Diameter {gal) (gal) <br /> CALCULATION `n � (i <br /> a� o r y� 2 I 4 6 7 <br /> �� �� 0 16 I fl 64 I 1 44 <br /> PURGING DATA <br /> Purge Method VACG� k2n —1-7Q-(--(-C Purge Depth sC E'/V Purge Rater- <br /> Time �} A = _ iS�� <br /> Volume Purges(gal) <br /> Temperature <br /> pH <br /> Ll <br /> Specdic Conductivity(umhos) <br /> Turbidity/Color ` _ - I�l)� <br /> Odor <br /> 'Casing Volumes Removed 1 <br /> 1 SY .w r- may_ t <br /> Dewaiered� <br /> Comments/Observations <br /> SAMPLING DATA Time Sampled �21 Approx Depth to Water During Sampling t <br /> Comments <br />' - Volume Shipped Unger Chaim <br /> SampleTNmber of Contacner Filled ql Custody at <br /> Under <br /> aaC Analysis <br /> Numbertamers Type PreseavauveLmL or L} Turbidity color <br /> /N) Method Comments <br /> RWz I IVDA I hCC I ML- I � N9 rM1E1 <br /> Z I I Voo� 4amt ;, ICU � 5-'7�6 0 <br /> I i I <br /> otal Purge Volume LR 61ALt-ONS DlsposaXontalnment Method at Lep, 7-0 RL7l1�L t� <br /> eatherCcnditlons <br /> Condition of Well Box and Casing at Tl of Sampling <br /> Well Head Conditions Requiring Correction(locks,damaged casing Orwell box,etc ) <br /> Problems Encountered Dunng Purging and Sampling f+ <br />' Comments <br /> PMS PRCU 7EMa P0RvS PURG'c10% <br />