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S�3; <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name Cb Well No x/1/1 w) 2 Date 11-11—F7� <br />' Project No sl`�� G� ���� Personnel C .`2-1 Q44 v' <br /> GAUGING DATA <br />' Water Level Measuring Method '`/Ti2F.4r�c_ ROZoe;c= Measuring Point Description <br /> Casing Total Req d <br /> WELL Total Depth Depth to Water I Water Column Multipiierfor Volume Purge Volume <br /> VOLUME (feet} .� {feet} _ {feet) TC Cas�ngDiameter (gal) (gal) <br /> CALCULATION <br /> olI2 ZZ 2� 1-7 2 I I '? 31610641144 <br /> 1 , <br /> PURGING DATA <br /> Purge Method rbc trK Purge Depth sC1q-ie7r1%J Purge Rate <br /> Time__ r A _ I !<Z{j I lZi $ f221 1224 <br />' Volume Purges{gal} <br /> Temperature(° <br /> l - �_ = g, 13 g, 19 1 �Yi 10 gNAM <br /> v� <br /> _Specific Conductivity{umhos} rr` ; (QCT (o ¢ 703j <br /> ' L;r iColor <br /> PW dstylco ` <br /> r l <br /> MOdor rz a - ;; . Sr <br /> r.lb [\I D <br /> a.�6— rye <br /> Casing Volumes Removed Y: <br /> =._Dewatered7'-�5^" `=y ' x X-6 <br /> Comments/Observations <br />' SAMPLING DATA Time Sampled 123c7 Approx Depth to Water During Sampling �`3 <br /> Comments <br /> Volume Shipped Under Chain <br /> sample Number of Container Filled of Custody at 413C Analysts <br /> Number Containers Type Preservative TL or L! Turbidity Color hfl Method Comments <br /> .n t tw/2-I IVDA I li GL {U"i-- I lArt—` I <br /> r I I <br /> I I I <br /> I I 1 <br />' Total Purge Volume bAL-s_oNS DtsposaVContainment Method -MAtC,E _ 7-0 R -L c- <br /> leather Conditions Ct"UCA'-1 <br /> indition of Well Box and Casing atT1me otSampling 0-K <br /> 11Head Conditions Requiring Correction(locks,damaged casing orwell box,etc } rvd <br /> alems Encountered During Purging and Sampling <br /> %tents <br /> TrMP FGRMs,PUAGct096 <br />