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GROUNDWATER PURGE AND SAMPLE FORM <br /> F, Projec <br /> ectName CxxbN Well No OLIT -�'tUl Da'- <br /> iNo S/S �� �2 - ����� Personnel �, -lS [H4%t3v'iFnl <br />' GAUGING DATA <br /> Water Level Meas firing Method Measuring Point Description i C%t_ <br />' aI <br /> WELL Total Depth Depth to Water Water Column f Multlplterfor sing Total Req d <br /> VColume Purge Volume <br /> VOLUME (feet) (feet) (feet) X Casing Diameter {gal) (gal) <br /> CALCULATION — <br /> iq 1.S 5 :;- <br /> I1 I 3 <br />' 01-01064 1 1 44 � 1 r - <br /> PURGING DATA <br /> Purge Method , VACL--uryo Purge Depth SCIS 0\1 Purge Rate ZY <br />' Time:=w l -f I /`�'c, �_3 LP 1- 3-7 <br /> Volume Purges y <br />' `Temperature(°Cr- <br /> pH <br /> _SpecrftcConducUvtty(umhos)=Y d <br /> :Turbidity/Color <br /> _ <br /> Casing Volumes <br /> Dewatered'? <br />' Comments/Observations <br />' SAMPLING DATA Time Sampled _ Approx Depth to Water During Sanoling r <br /> Comments <br /> Volume Shipped Lender <br /> Sample Nuber of Container Chain <br /> nAnalysis <br /> Number Containers Type Preservative mL o U Turbidi,y Color I o!custodyat a C Method Comments <br /> IVDA I cum I `� "g �I <br /> Aft <br /> I I I I 1 I <br /> # I I I I 1 <br /> atal Purge Volume Disposal/Containment Method Tom!LcEg 7-0 fZ,C?[L -L<— <br /> IWIeat her CondlUons <br /> Condition of Well Box and Casing at ime of Sampling <br /> Well Head Conditions Requiring Correction(locks damaged casing orwell box etc ) f <br /> Problems Encountered During Purging and Sampling <br /> Comments <br /> PMS PROJ TEMP FORMS PURGE10% <br />