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' GROUNDWATER PURGE AND SAMPLE FORM <br /> Protect Name C'�Xb Well No �� Date <br />' Protect No Personnel CH/R,5 <br /> GAUGING DATA <br />' Water Level Measuring Method 2E O ,c= Measuring Point Descr,ptlon SCC <br /> Casing Total Req'd <br /> WELL Total death Depth to Water Water Column Multiplrerfor Volume Purge Volume <br /> VOLUME (feet) (feet) (feet) X Casing Diameter (gal) <br /> CALCULATION — !! <br /> ?D c>-7 Z-q. b� t6 <br /> 0 16 i0 64 i <br /> PURGING DATA <br /> Purge Method fiGu e2 1_7Q_ �r Purge Depth Purge Rate <br /> Time--_ <br /> Volume Purges(gai) _ �~" ! 3 5-7 <br /> -Temperature --wy' <br />' _ZSpecr€ic Conductivity(urnhos)�„ (o �� I (07Alull <br /> (� ! <br /> Jurbid yIColor <br /> �` <br /> �Cast ngVolumesRemoved <br /> .Dewatered7 <br /> Comments/Observations <br /> 1 <br />' SAMPLING DATA Time Sampled l E U Approx Depth to Water During Sampling 2- 1 <br /> Comments <br /> Vol ume - Shipped Under Chan _ <br /> Sample Number of Container Filled of Custody at 4oc Analysis <br /> Number Containers Type Preservative (mL or L) Turbidity Color (,mss Method Comments <br /> J <br /> Ivor, orn L_ 1171 FE <br /> hCL 1-101111 <br /> i i i i i i i <br /> Total Purge Volume 6ftLt r3rUS DtsposaVGontatnment Method <br /> *Weather Conditions c" tri <br /> Condition of Well Box and Casing atTime of Sampling ¢� <br /> Veit Head Conditions Requiring Correction(locks,damaged casing orwelt box,etc ) C> <br /> oblems Encountered During Purging and Sampling <br /> nments <br /> r _ r <br /> _a 7EviP FORMS PURG'c10% ~ <br />