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IAO� <br /> GROUNDWATER PURGE AND SAMPLE FORM Date- nq-"�4 �fiS <br /> Project Name* ... ��� � 7���I`f'� Well Number �LA) <br /> rolect Number —&3-73q a Personnel <br /> GAUGING DATA <br /> Water Level Measunng .Methodhk-4-40� <br /> — Measuring Point Dest:nptzon <br /> Total Depth Depth To Water Water Column Multiplier For Casing Total Req'd <br /> WELL (feet) (feet) (feet) Casing Diameter Volume Purge Volume <br /> VOLUME (gal) (gal) <br />;�A�LCULA'171014 ttt� � X " <br /> 9 go q- l a 3. g zfi a. 4 03 5'a <br /> PURGING DATA v Purge Method: �C �-4 Ck <br /> Purge Depth• Purge Rate 'v <br /> Time <br /> Vofume Purged (gaff <br /> Temperature �' . . 02 a� Q r�� Q a <br /> ! 1%. - <br /> Specific Conductivtty (9"os) 1 ;;�d 1 UL�o loso 10 <br /> rbldtty iColor <br /> 1 b�' <br /> Odory? \ J 1 S1 <br /> Casing Volumes Removed Q 1 <br /> Comments/Observatsons- <br /> AMPLING DATA Time Sampled . Approx Depth to Water I <br /> During Sampling <br /> Comments <br /> r - c _ <br /> ped <br /> + vuner 5noj <br /> s.rtp+ RMadyP vim =a.a <br /> -own T� fw � ( l tx Tuk%AT W cantfdy <br /> _ <br /> color e!a'C(Y1M IlAsthod Cor xnu+e. <br /> 201 4.0 10L_1 C(Ocr #� l <br /> t Purge Volume �O S Disposal/Comainment Method. s <br /> v i <br /> her Conditions M <br /> ondition of Well Box and Casing at Time of Sampling <br /> e Head Condgions Requiring Correction (locks damaged casing or well box etc ) N <br /> Problems Encountered During Purging and Sampling <br /> 1omments <br />