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GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name CXXC>/t-_ _ Well No R'vJ.3 Date I Jq f 9(v <br /> Project No 515 3 4Q7_ _ Personnel _ G."" a 14 0 _ <br /> GAUGING DATA <br /> Water Level Measuring Method If! ca_ R"Q be Measuring Point Description —1 o C <br /> Casing Total Req'd <br /> WELL TotTi <br /> Depth to Water Water Column Multipherfor Volume Purge Volume <br /> VOLUME (fest) (feet) CasingDtameter (gal) (gal) <br /> CALCULATION 2 4 6 <br /> Q23 q 4A 2 5 Coca o a 64 44 I(o. 2 �q 2-1 <br /> PURGING DATA <br /> Purge Method Vickr-u lrn �i'rUcK Purge Depth -15ce-go-n Purge Rate !;�Ryri <br /> tATiime� 'r `MS a°- IZ 31 12 3y 12 3� IZ 3g <br /> Volume Pur es al <br /> s (g ) �.� = =� 4(i 33 1-19 <br /> Temperature(°C} ! Cl 3 S Cl 4 <br /> PHM <br /> $.00D 4 02 Q 0 <br /> Sp � <br /> � u10011 <br /> w <br /> _ ecdic Conductivity(umhtO 100-5 1Q!2 <br /> 1wTurbEdy/Color <br /> raw,% <br /> Odor,-','- C <br /> r � 1-4 C <br /> Casing Volumes♦HYr <br /> -Devvatered? <br /> a'4 r'J <br /> r� <br />' Comments/Observations <br />' SAMPLING DATA <br /> Time Sampled 1 x Z _ Approx Depth to Water During Sampling <br />' Comments <br /> Volume Shipped Under Cham <br /> Sample Number of Container Filled of Custody at 40C Analysis <br /> Number Containers Type Preservative mL or L Turbidity Color (YIN) Method Comments <br /> vdo"5 HC I 4or.-0 -17H-q <br /> 1 <br /> otal Purge Volume 5 O Disposal/Containment Method <br /> Weather Conditions C o V <br /> ConditionofWell Box and Casing atT eofSampling --5—K <br /> Well Head Conditions Requiring Correction(locks,damaged casing orwell box,etc) _ <br />' Problems Encountered Dunng Purging and Sampling - <br /> Comments <br /> PMS PR31 YEMP FomvM PIJFC;=1'%K <br />