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GROUNDWATER PURGE AND SAMPLE FORM <br />' Project Name Exxafl__ __ Well No MW H Date 11 <br /> ProjectNo Personnel _12 testi a II o <br />' GAUGING DATA <br /> Water Level Measuring Method 2nici- ca P-06-:z Measuring Point Description —i e _ <br />' Casing Tota[Req'd <br /> WELL Total Depth Depth to Water Water Column Muftiplierfor Volume Purge Volume <br /> VOLUME (feet) _ (feet) (feet) X Casing Diameter (gal) _ (gal) <br />' CALCULATION 2 4 6 <br /> 30 . '1 U 21 5 5 Q S5 0 16 0 64 � 44 5,(a(r 16 �q <br />' PURGING DATA <br /> Purge Method \A:%CLtlr-n Trycl< Purge Depth Scr¢an Purge Rate 5 -1 qer . <br /> Time } J�- I! 11 I,I ' Ird It lot It 20 <br /> Volume Purges(gal)- ;-z S S I <br /> Temperature(,C) ' x I q 3 19 TC 1 q 191 <br /> ,^,V r.�-.rte;,�..... <br /> ���� 1 7 -1 <br /> Specific,Conductrvity(umhv p 5 <br /> 1001 99 4 <br />' -t;`Turbidity/Color <br /> �., <br /> Or '^10, ^ ';: _ ' � ti> H C 1 t <br /> "1.ii{1•.�G'Lrt4P�'�Jk.A'..F"n"` <br /> R Casing Volumes Removed � '�� 2 3 <br /> Dewatered� V N <br /> Comments/Observations s <br /> SAMPLING DATA <br /> Time Sampled 0 23 Approx Depth to Water During Sampling 2(p <br /> Comments <br /> Volume Shipped Under Cham <br /> Sample Number of Container Filled of Custody at 4 <br /> 0C Analysis <br /> Number Containers Type Preservative-_ mL ort Turbidity Color !N Method Comments <br /> _TFH-q <br /> W <br /> MM[ vot�5 C 1 4for..t l ew clac.- i�CT <br /> otal Purge Volume 11 Disposal/ContainmentMethod }nc„,ic _ <br /> k <br /> eatherConditions G <br /> Condition of Well Box and Casing at ime of Sampling 1 <br /> Well Head Conditions Requiring Correction(locks,damaged casing or well box,etc) <br />' Problems Encountered During Purging and Sampling N <br /> Comments <br /> O V 5 PA,^^J 7E V p CAM V C pt 1pGc j,74i <br />