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i <br /> IGROUNDWATER PURGE AND SAMPLE FORM <br /> ProlectName Well NoDate <br />' ProlectNa Personnel GH,QI� CNS'ic�'R>\l <br /> GOUGING DATA <br /> Water Level Measuring Method1'`/Tr R�.4{ PRy E Measuring Point Description �C <br /> volume Total Rzq'd <br /> WELL Total Depth Depth to Water Water Column Multlplterfar Volume Purge Volume <br /> VOLUME (feet) (feet) (feet) Casing Diameter al <br /> (g ) (gal) <br /> CALCULATION � n X 2 1 4 6 �J <br /> o 1l � �� 016I064 144 <br /> PURGING DATA <br /> Purge Method Vi CLC- �Yyq � Purge Depth SCR-e-E-/V Purge Rate 3 <br /> erne _ - I l 4-D S I 4 V 7 t t 4) OL <br /> Volume Purges(gal) <br /> x~ ( ! I I <br /> ti Temperature(°C)- 't t =- "- d D I Q� 2-C.) .-j ZUpH <br /> 3 <br /> _ " .�." s <br /> - _ . - 7. 53 17. 4J <br /> 5 I -7 --73 <br /> Specrflc Conductivity(umhos)F <br /> t,w `per 1 ,cs� 1uuF <br /> Turbldity/Color - _ . - ' Com{ Cts t2cfir f <br /> -Odor y-.. =` '° ND �CJa <br /> tCastngVolumesRemoved -2- 3 <br /> -_ u <br /> 4. <br /> Dewatered? <br /> Comments/Obaervatlons <br /> SAMPLING DATA Terme Sampled Approx Depth to Water During Sampling <br /> Comments <br /> Volume Shipped Under Cham <br /> Sample Number of Container Filled of Custody at aoC Analysts <br /> Number Containers Type Preservative ml_ or L) Turbidity Calor �yy Method Comments <br /> Mw I IVDA ACL L <br /> Total Purge Volume ZZ btu-al�� DlsposaVContainmentMethod T1zAiLE -rD Eon4L-c- <br /> eatherConditions [tc3'j CA -,_ _ <br /> Condition of Well Box and Casing atTlme of Sampling D C <br /> Well Head Conditions Requiring Correction(locks,damaged casing orwell box etc) <br /> Problems Encountered During Purging and Sampling <br /> Comments <br /> PM5 PROJ7EMP FORMS PURGE 10% <br />