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GROUNDWATER PURGE AND SAMPLE FORM <br /> ProlectName Well No _ RW Date_ Iq1 <br />' Project No 515 L(Z. 13()L:) Personnel �C3c�-„Q��c� <br /> GAUGING DATA <br />' Water Level Measuring Method � ��iruc¢ }�rn� _ Measuring Point Description <br /> Casing Total Req'd <br />' WELL Total Depth DeptAWaler Water Column Multiplierfor Volume Purge Volume <br /> VOLUME (feet) (feet) XCasing Diameter (gal) (gal) <br /> CALCULATION2 4 64q 1S 1 Cl3015 0 16 0 64 1 44 I <br /> 1 <br /> PURGING DATA <br /> tPurge Method VOQ VVrv-'t ]ruck Purge Depth C Purge Rate $ 3 $gr'1 <br /> Lic It 30 It 53 11 55 <br /> Volume Purges(gal)�t+ ; y:- S 9 <br />' rTer'npe"rature(°,C)<� .;; e i{Q q i $ CD l 1 g <br /> ." . _ ; `113 `� (9% <br /> - rf «_ <br /> SpecrficCondiicttvitjr(umEtos) ' S2C) S Oq %31 <br /> _TurCidi /Color <br /> Odor, <br /> Casing Volumes Removed=�_"__ O 1 Z <br />' Dewalered��r4 �i*' '” J f� <br /> t11 <br />' Comments/Observations <br /> SAMPLINGDATA Time Sampled Il 5g _ <br /> p Approx Depth to Water During Sampling 23 <br /> Comments <br />' Sample Number of Container Volume Shipped Under Chain <br /> Filled of Custody at 40C Analysis <br /> Number Containers Type Preservative mL or t. Turbidity Color 1N Method Comments <br />' YHC1 t u wM <br /> Total Purge Volume 5 Disposal/Containment Method QG K 1S <br /> Weather Conditions C Iw <br /> Condition of Well Sox and Casing atTifne of Sampling O <br /> Well Head Conditions Requiring Correction(locks,damaged casing orwell box,etc � <br /> Problems Encountered During Purging and Sampling <br /> Comments <br /> PA'S <br /> PR-'U TEMP Fcwwz PUF4GF 1096 <br />