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GROUNDWATER PURGE AND SAMPLE FORM p <br /> F� Project Name _ C�C7C6/y Well No _1z� L4 Date - 3`�O <br /> Protect No s/5 �� �2 , 13C��� Personnel C' IpD� <br /> 1 GAUGING DATA <br /> Water Level Measunng Method N7iQ�.G7r� - Measuring Point Qesc Iptlon <br /> 1 Casing I I Total Req d <br /> WELL Total Depth Deoth to Water Water Column MuiLoller�o� I <br /> !f Volume Purge Volune <br /> VOLUME <br /> (feet) (feet) (feet} Casing Diameter g <br /> CALCULATION 4 . — (gal) — (gal) <br /> re 11 <br /> 1 2`' 016 10 64 11 4� <br /> PURGING DATA <br /> Purge Method „Ar-I C.Lc_u.tnM i-R�t�1C Purge Depth SC1?-Ce/U Purge Rate C� ✓� <br /> Time- znH I <br /> Volume Purges(gal) 4 A=�� - (� I ice <br /> �} I 5 <br /> TempeMratur'e.[°C �? <br /> , �-`•_ <br /> i <br /> � - ` _ _ � ! /• I l7. 7. <br /> --- tS , �'3 � �6 •D?JI 7_ Co8 �. U! <br /> r_M <br /> _Specrfrc Conductivtty_(iJmhos} - I � 3l �09 <br /> ! <br /> ,7t7rbidtty/Color .. ='= ��� IDi"� 1rJs I (011 <br /> tet- - �QGf1( Uw <br /> Casing Volumes Removed; -y <br /> �Dewatered'? `�:, <br /> Comments/Observations <br />' SAMPLING DATA Time Sampled Approx Depth to Water During Sampling l? <br /> Comments J <br /> Sample number of Container Volume Shipped Under Chain <br /> p I Filled of Custody at aoC I Analysis <br /> Number Containers Type Preservative (m� or Z) Turbidity Color INS Method Comments <br /> I � IVDA I Hcy I�,:rn�. I vw I Irl y <br /> otal Purge Volume Disposal/Containment Method 7]Ai c, 71i r_C= <br /> rgnll <br /> eatherCondthonsdltionofWetl Bax and Casing ai Ime of Sampling <br /> Head Conditions Requiring Correction(locks damaoedt:asing Orwell box,etc ) v <br /> Problems Encountered During Purging and Sampling �y <br /> Comments _ �_...—..... <br /> PMS PROJ TrzMP FORKS PURGEIC96 <br />