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GROUNDWATER PURGE AND SAMPLE FORM <br /> Protect Name Exx _ Well No __ 1ZVJ�{ _ Date 2 (3 fq1 <br />' Protect No 5 15 Lt Z. 13 U CD Personnel <br />' GAUGING DATA <br /> Water Levet Measuring Methodrttr� c¢ lira 1� _ Measuring Point Description —MC- <br /> Casing <br /> WELL Total Depth Depth to Water Water Column Mufti lierfor Casmg Total plum <br /> p Volume Purge Volume <br /> VOLUME (feet) (feet} (feet) X Casing Diameter (gal) (gal) <br /> CALCULATION <br /> 2 4 6 <br />' 44 `1U 71 Ll0 2.33Q d16 064 <br /> PURGING DATA <br /> IPurge Method Vac UUm 1r'uc kC Purge Depth Purge Rate S <br />' Time <br /> M ()q zq 09 Z(v 09 Z9 G9 32 <br /> Volume Purges(gal)s 30 <br /> s. ...A .s 1 <br /> Temperature(°C)_. Q,y "" <br /> GI <br /> Ito -1 38 3q -1-39 <br /> -7Specrfrc Conductivtty(umhos) K Q ILl U q3� 01 g �}'I Z <br /> Turbidity/Color <br /> rQ <br /> r Odor:rte C <br /> t-4C H C I C <br /> Casmg Volumes l�amovedz�';...-`:�= O 1 � 3 <br /> Dewatered7_ <br /> - - tJ N <br /> Comments/Observations <br />' SAMPLING DATA Time Sampled Ol 35 <br /> p Approx Depth to Water During Sampling Z3 <br /> Comments <br />' Sample Numt�r of Container Volume Shipped Under Chain <br /> Filled Custody, °C Analysis <br /> Number Containers Type Preservative mL or L Turbidity Gator oM at 4 Method comments <br /> 3 Y H(J I o-^+ I'�...r I r N-9 <br /> firvc mr 4 <br /> I W, <br /> EE <br /> Total Purge Volume ' f rJ Disposal/ContainmentMethod DQ K <br /> Weather Conditi ons I w <br /> Condition of Well Box and Casing at 1 i e of Sampling 01 <br /> Well Head Conditions Requiring Correction(locks,damaged casingorwel!box,etc) <br /> Problems Encountered During Purging and Sampling <br />' Comments <br /> PVS PR61 TEMP r0-'7MS PURCE 7095 <br />