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ao <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name --'--� Well No W-1 Date w q-1 <br />' ProjectNo _ 5_I_53 q L{2: BOLD _ _ Personnel <br />' GAUGING DATA <br /> Water Level Measuring MethodMeasuring Point Description C <br />' Casing Total Req'd <br /> WELL Total DepthEDepth to Water Water Column MUlhpherfor Volume Purge Volume <br /> VOLUME (feet) (feet) (feet) X Casing Diameter (gal) {gal) <br /> CALCULATION <br /> 2 4 6 <br />' ZZ (oZ SS 5 4 `{ 0 16 4 64 144 3 23 9 Cob <br /> PURGING DATA <br /> Purge Method Vac UUrrn 1rUC k- Purge Depth C Purge Rate 3 <br /> - <br />' it 0q t U y <br /> Volume Purges(gad x` ,.,�:�1 tA ' 3 <br /> •'�" -c`rr' O <br /> Temperature(°C) - CoI ZO <br /> � <br /> Specific Conductivity(umbos) ; p 0 I O 13 <br /> ... x <br /> Turbidity/Color <br /> t Odor, <br /> N N N r� <br /> -Casing Volumes Removed t <br /> -r Z <br /> Dewatered? <br />' Comments/Observations <br /> SAMPLING DATA Time Sampled 1 <br /> P Approx Depth to Water During Sampling Z.U <br /> Comments <br />' Volume Shipped Under Chain <br /> Sample Number of Container a=ided of Custody at 4°C Analysis <br /> Number Containers Type Preservative I mt or L Turbidity Calor Method Comments <br />' 3 Y ! FiQ <br /> ravel I �aK Nf"� <br /> Total Purge Volume t c7 Disposal/ContainmentMethod 9c K n- 1,>,K <br /> Weather Conditions dou <br /> Condition of Well Box and Casing at Time of tampling <br /> Well Head Conditions Requiring Correction(locks,damaged casing or well box,etc�1 <br /> Problems Encountered During Purging and Sampling N <br /> Comments <br /> PW5 PRO,}TEMP FORS✓.?PURGE1096 <br />