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GROUNDWATER PURGE AND SAMPLE FORM <br />' Project Name c yc"') Well No Mw q Date 11�,4 1q& <br /> Project No 515 3 QQZ Personnel Gzw,�, a It o <br />' GAUGING DATA <br /> Water Level Measuring Method U:C! -•Gca R--o 6e Measuring Point Description i o C <br />' Casing Total Req'd <br /> WELL Total Depth Depth to Waterk <br /> r Column Multiplierfor Volume Purge Volume <br /> VOLUME (feet) .. (feet) feet) X Casing Diameter (gal) (gal) <br /> CALCULATION 2 29 (08 zl q � y ops as4 17; H 95 <br />' PURGING DATA <br /> Purge Method Vers, lin -T132CK Purge Depth 5C'r¢an _ Purge Rate 3.15 clay^-� <br /> Time <br /> _ wv. 11 0 (0 11 01 l 1 O l i <br /> Tern <br /> olume Purges(gal) . ;� <br /> N,��.✓ <br /> perature(°C) }Q (� 20 Z 2 U Cfl <br /> D. <br /> tin 12% <br /> Specific Conductivity(umbos} S p g s y 73 H %7_0 <br /> , Tuibidrty/Color �;��'���}�ti I`'•..` � to..-� Imo•,-• Imo..,, <br /> Odor," ` H L <br /> Casing Volumes Removed' <br /> .- <br /> Dewatered? <br /> Comments/Observations <br /> ISAMPLING DATA <br /> Time Sampled %I I ?)_ Approx Depth to Water During Sampling 21 <br /> Comments <br /> Volume Shipped Under Cham <br /> Sample Number of Container Flied of Custody at a°C Analysis <br /> Number Containers Type Preservative mL or L Turbidity Color /N Method Comments <br /> W 4 voots 1-1C I 4or+I 10— <br /> Total Purge Volume 115 Disposal/Containment Method +zXAl r•�i <br /> Weather Conditions C1 0uA <br /> Condition of Well Sox and Casing at Vne of Sampling el 1 <br /> Well Head Conditions Requiring Correction(locks,damaged casing or well box,etc) N <br /> Problems Encountered During Purging and Sampling - - -_— <br /> Comments <br /> PMS PR,^.,'TEMP PC)QMC Pt7RG=t'1aF <br />