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1 <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name XCWI Well No M W I? Date 11 <br /> Project No 515344#Z Personnel __iZ_ a 110 <br /> GAUGING DATA <br /> Water Level Measuring Method M(Tlm a_- A"o�ne Measuring Point Description o C <br /> 4CasingTotal Req'd <br /> WELL Total Depth Depth to Water Water Column Multipllerfor urgeVolume <br /> VOLUME (feet) (feet) (feet) X Castng Diameter (gal) <br /> CALCULATION 2 4 6301 12 Z5,3 i 1L} H S 0 i6 0 64 144 41 <br /> PURGING DATA <br /> Purge Method VoxCWr+n _'rVCK Purge Depth Screon Purge Rate H Cr oarn <br /> Time..._ <br /> 10 .20 10*.ZZ I0 Z1I IO Z <br /> Volume Purg(s(gal) <br /> Temperature(°C] • =�=y°^ - e� .Z L Q `-t $.$ I B (o <br /> 4 05 % 05 6 C 35 <br /> Specdic Conductivity(umhos) 5�n 10 0 3 <br /> 10 7-rd 10514 I fl Z3 <br /> '�=Turbid ;E = y$ I ow 1 a v+ aw 1 a.+ <br /> S� ttylColor a_ <br /> d C qcv/ Q <br /> Odom x; � ti` Mxy f� N tom) <br /> lv <br /> Castng Volumes Rem <br /> ovedl *� t 2 3 <br /> iComments/Observations <br /> SAMPLING DATA <br /> Time Sampled _1 0 3 D Approx Depth to Water During Sampling Z`l. <br />' Comments <br /> Volume Shipped Under Chain _ <br /> Sample Number of Container Filled of Custody at 40C Analysis <br />' Number Containers Type Preservative mt.or L Turbidity Color !N Method Comments <br /> 1 �H-? <br /> Iz voo�S tic I 1-I0rr+t to,. 42n grex <br /> I <br /> Total Purge Volume 2 DtsposaVContainment Method {':-„lam -iQ Qor^i c <br /> Weather Conditions ._ C t-Vdu <br /> Condition of Well Box and Casing at Ti a of Sampling OK <br /> Well Head Conditions Requiring Correction(locks,damaged casing or well box,etc ) ty <br /> Problems Encountered During Purging and Sampling N <br /> Comments <br /> vV9 PRaj TEVO FC)ah <br />