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GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Narne C��a� Well No ._ �" 4-VLL Date <br /> ProlectNo Personnel _CH,EtS <br /> GAUGING DATA <br /> Water Level Measuring Method R0-QC-,E- Measuring Point Description J� <br /> Casing ota[Req d <br /> WELL Tota!Depth Depth to Water Water Column Multiplier Volume urge Vofurne <br /> VOLUME (feet) f.t (feet) (feet) Casing Dtarneter (gal) IPT <br /> (gal) <br /> CALCULATION <br /> L 2 4 I 6 <br /> ? Cr I c.f . 6v II 016064 11 44 J I <br /> PURGING DATA <br />' Purge Method V LCrl^ `!nuc � Purge Depth SC?q-ie7��V Purge Rate <br /> Time _ - - - - _I /� r� � w � ;7I / may/ <br />' Volume Purges(gal) <br /> -Temperature(°G) <br /> pl t- _ --7D i <br /> �Y g <br /> Specffic Conductivity(umhos)_ L>> € �% 4� <br /> Turi�idtty/Cor <br /> io �` - v <br /> -=Casing Volumes Removed <br /> pDewater`ed A,0 i✓CJ -t J �,�j <br /> Comments/Observations <br />' SAMPLING DATA <br /> Time Sampled �� ^_ Approx Depth to Water During Sampling <br /> f <br /> Comments <br /> Volume Shipped Under Chain <br /> Sample Number of Container Filled of Custsdy at AOC Analysis <br /> Number Containers Type Preservative (mir or Ll Turbidity Color SNS Meth-1 Commenls <br /> IVDA hCL ML � G' It�+`Y � �' 1� I� ''g I'm SEI <br /> Total Purge Volume LJbAu-��N� Disposal/ContalnmentMethod TZAiC.e T7 A-Zc� <br /> *Weather Conditions =0 f <br /> Condition of Well Box and Casing atTi e of Sampling } L.'- <br /> Well <br /> .'Well Head Conditions Requiring Correction(locks,damaged casing Orwell box etc ),-(\, <br /> Problems Encountered During Purging and Sampling <br /> Comments <br /> PM5 PRp.1.TE.MP FORMS PURGE1096 <br />