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1 <br /> GROUNDWATER PURGE AND SAMPLE FORM <br />' Project Name ccxc'n _ Well No W z Date 11. <br /> Project No 515 3 q44 _ Personnel ��_ ► a 14 0 <br /> GAUGING DATA <br /> Water Level Measuring Method 7:'! -eac R-Ot-Dg Measuring Point Description —t C <br />' Casing TOtat 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 6 <br /> Hq sB2 CV z�.2 d 0161064 14.4 17 4.41 52 zZ <br /> PURGING DATA <br /> Purge Method Vacwr-) -2VC114, Purge Depth Scr¢a Purge Rate 3,1 <br />' Time <br /> y r - 12 53 12. 55 f2 5 12 5 CJ <br /> Volume Purges(gal)'�T �� O S �� <br /> Temperature(° <br /> Iq 1 19 q zO, U <br /> 0 <br /> Specrftc Conductrvtty(umM-:. C1�,rj pl H5 93& 9 2 S <br /> _ hoCrs)u k <br /> }5r .a .. .- r `"cY�'}7Y-s't •< 11.iIy� �.-j <br /> §-TUrbidity/Color_-, <br /> E- <br /> a�.'S <br /> Casing Volumes Removed'.- O <br /> Deivatered� y - N N N N <br /> tComments/Observations <br /> SAMPLING DATA Time Sampled 13 • D? Approx Depth to Water During Sampling Z <br /> Comments <br /> Volume Shipped Under Chan <br /> Sample Number of Container Filled of Custody at 4°C Analysis <br /> Number Containers Type Preservative mL or L Turbidity Color /N Method Comments <br /> "7PH-q <br /> 12%4 Z via" HC.I y0 r+t ,..1 <br /> 1 <br /> FWeotal Purge Volume 5z S Disposal/ContainmentMethod �' t -It <br /> r-atherCondttions <br /> Condition of WelIBoxandCasingatTim of Sampling 11C <br /> Well Head Conditions Requiring Correction(locks,damaged casing or box,etc) <br /> Problems Encountered During Purging and Sampling <br /> Comments <br /> -M5 PRCU TEMP F:novq o114G� ^i4: <br />