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1 <br /> 6M GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name ori Well No1 Date i i <br /> Project No 5 t5 3 g447— Personnel _ I�C3�r++ a I,o <br /> GAUGING DATA <br /> Water Level Measuring Method :IetC 9--o Measunng Point Description o C <br />' Casing Total Req'd <br /> WELL Total Depth Depth to Water Water Column Multipllerfor Volume Purge Volume <br /> VOLUME (feet) (feet) (feet) X Cas ng Diameter <br /> CALCULATION s (gal) T <br /> (gaI) <br /> 25.q-1 01 4 6I(, (02 8(9 <br /> 6 0 64 1 44 <br />' PURGING DATA <br /> Purge Method Vo�CuVr-% _T;-uCK Purge Depth Scr¢a Purge Rate G 25 Q?_Y"% <br />' :Time 15 140 I 113 i 3 q!5 13 jig <br /> Voluttie Purges(gal) " <br /> 5 33 50 <br /> Temperature(°C) jig I ! B $ f 4 <br /> = 0 <br /> Oq <br /> Speclf c Conductivity(umhos)� $JJr Q 3 5 g g $4 <br /> Ttirbiddy/Color " — �a� n"a"+Ur' low l o� Iter. <br /> ` r>­�, ea%WeNro C I <br /> Odor: HC <br /> -Casing Volumes Removed <br /> . 2 3 <br /> _ Dewatered? Y` <br /> 1v r� N N <br /> iComments/Observations <br />' SAMPLING DATA Time l 3 5 i <br /> e Sampled Approx Depth to Water During Sampling .z$ <br /> Comments <br /> Sample Number of Container Volume Shipped <br /> oopped Under Chain <br /> f Custody at 41C Analysis <br /> Number Containers Type Preservative mL or L Turbidity Color !N Method Comments <br />' N vaot5 1-4C1 Ljor'+1 Ipw Ito✓ greN <br /> 1 <br /> otal Purge Volume X.1? U Disposal/Containment Method -11-Col lar _�o Qo r^_ t C <br /> Weather Conditions CID <br /> Condition of Well Box and Casing atTirAeof Sampling mak_ <br /> Well Head Conditions Requiring Correction(locks,damaged casing orwell box etc) r J _ <br />' Problems Encountered Dunng Purging and Sampltng t� <br /> Comments <br /> oM5 PF J TEMo FngMC ot)pC^+,- <br />