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GROUNDWATER PURGE AND SAMPLE FORM <br />' Project Name CXXC.1 Well No _. M W 1 3_ Date 11.1,q J9&_ <br /> Project No 515 3 RQ 7- Personnel ++ ¢}} <br /> GAUGING DATA <br /> Water Level Measuring Method tt:jeMeastaring Point Description a'O C <br />' Casing Total Req'd <br /> WELL Total Depth Depth to Water Water Column Multlpllerfor Volume Purge Volume <br /> VOLUME (feet) (feet) (feet) X Casing Diameter (gal) _ (gal) <br /> CALCULATION 2 4 <br />' HSI ZZ 2t013Co II QU �I "�3 r3�4,2 <br /> 016 os4 144 <br />' PURGING DATA <br /> Purge Method V en IrIvcK Purge Depth SCr¢a­) _ Purge Rate <br />' Time-_ <br /> awe`<fi 0 31 10 3.3 101,55 1 <br /> .- <br /> v <br /> Volume Purges(gal) x tiF O 1 1 5 2.3 <br /> � S <br /> Temperature{° <br /> ,PH, ^ <br /> 1G � qg -199 <br /> x Specrfic Conductivity I D 83 I 0151V 1 0 1 1 0 J! U <br /> `,Turbtdrty/Calor <br /> .Odor „ n1 <br /> Casing Volumes Removed cam`*. 2 3 <br /> Dewatered? <br />' Comments/Observations <br />' SAMPLING DATA <br /> Time Sampled Lu Approx Depth to Water During Sampling )_'ii <br /> Comments <br /> Volume Shipped Under Cham <br /> sample Number of Container Filledo Analysis <br /> Number Containers Type Preservative mf_or L Turbidity Color of Custody at 4C Method Comments <br /> Mw' li -Tpt-1- <br /> t3 vo 0,5 HC l low r <br /> Total Purge Volume Disposal/ContainmentMethod 0t1ar -+0 2Or^Cc <br /> Weather Conditions ... C I u u dy_ _ <br /> Condition of Well Box and Casing at Ti meo!Sampling a <br /> Well Head Conditions Requiring Correction(locks,damaged casing Orwell box,etc ) <br /> Problems Encountered During Purging and Sampling <br /> Comments <br /> PMS PgOjTEMP Fn4q/C P11RGF"Y�i <br />