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m <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> ry� - 1 r- ri- <br /> PrcjectName _ C�xb�,! Well No Date / <br /> ProiectNo SSS 3� G� / �C�t� Personnel c14 <br /> GAUGING DATA <br /> Water Level Measuring Method /''/7 c R �r E 2E ocSr Measuring Point Description <br /> Casing �JPTotal Req'd <br /> WELL Totaf Depth Deoth to Water Water Column Multiplierior Volume urge Volume <br /> VOLUME (feet) rr (feet) _ (feet) X Casing Diarneter (gal) _ (gal) <br /> CALCULATION 2 6 <br /> � 7- � 3 II L 10 1610'64 11 44 E �j� 41 <br /> PURGING DATA f / <br /> Purge Method YX!G -L'w/ Purge Depth SC1Ze7F1"1J Purge Rate - <br /> rme 3-3U 1�j32 l 334 1�i� I ! <br /> Volume Purges(gal) <br /> r_ <br /> "Temperature(°G}- , r v '- 1-7 <br /> Specrfic Conductivity(umhos)w 7-F? j a.� �f <br /> �.- <br /> kTurbidity/Color= 4 L'rr <br /> `=4 <br /> Odor=- K N" J=_ Ajo <br /> -Casing Vofumes Removed -» <br /> Comments/Observations <br /> SAMPLING DATA Time Sampled Approx Depth to Water During Sampling <br /> Comments <br /> - Volume Shipped Under Cham <br /> Sample Number of Container Filled of Custody at a°C Analysis <br /> Number Containers Type Preservative mL or!_) Turbidity Color Method Comments <br /> 1\/DA h CL I"rr)L. tom. I i <br /> Total Purge Volume &P"-VNSDisposaVContainmentMethod TRA[Le -moi? UL-ts— <br /> •Weather Conditions X cs Li — <br /> Condition of Well Box and Casing at Time of Sampling <br /> Well Head Conditions Requiring Correction(locks,damaged casing orwell box,etc) <br /> Problems Encountered During Purging and Sampling <br /> Comments <br /> PM5 PRO&TEMP FARMS PURGE10% r <br />