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' GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name _ C xbN Well No pw•a <br /> Project S/S �� `? . / U�� Personnel <br /> GAUGING DATA <br /> Water Level Measuring Method R,QOt,; = Measuring PointDescr,ption <br /> WELL Total Depth 1NZate�rC�olumnX Muiiofierfor Casing — <br /> ) total Re <br /> q dfle th to 4ater II ` I VclumePurge Volum <br /> eVOLUME (feat) (feet) (feet) Casing Diame <br /> —;-1 <br /> ter (gal) (gal) <br /> CALCULATION <br />' 011 � I I 0 64 I 1 --4� <br /> PURGING DATA <br /> r <br /> Purge Method r/�CC.t_u�lr, r'�c.cr`K Purge Depth sC_rZ�4!P71\J Purge Rate ✓� <br /> Time ; `"' _ I /pZ v Z i j�z� I /? <br />' u <br /> Volme Purges(gal) •`� <br /> _ - <br /> Temperature(°C) ,-1�' -- I U j� • Z <br /> pH <br /> -741 <br />�AskumhsrT r - <br /> 'Specrfic Conductivity( os) Z <br /> TurtsiditylCotor - v _ L 54r CLUT <br /> Ew' <br /> .odor"" <br /> ¢Casing 1/ofurnes Removed <br /> iLi4 ti. � 1 <br />' 'Dewatered <br />' Commentsl0bsewations <br />'a SAMPLING DATA Time Sampled I �3a _ Approx Depth to Water During Sampling <br /> b <br /> Comments <br /> Volume Shipped Under Chain <br /> Sample Number of Container Filled cl Custody al aoc Analysis <br /> Number Conialners Type Preservative mL or�i Turb�diry Color � } Method Comments <br /> l� n 1vo>� <br /> HC-C- C�r.�I � +� , � <br /> \Total Purge Volume Dtsposal/ContalnmentMethod TRA-JCC Tt� ULC— <br /> '10WeatherConditions r4-«^'1 <br /> ,onditionof Well Box and Casing at Time of Sampling <br /> dell Head Conditions Requiring Correction(locks,damaged c ng orwell box,etc } <br /> blems Encountered Dunng Purging and Sampling <br /> ?.Emments <br /> IPRWTEIAP FARMS PUFRGEiC% <br />