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' a <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> r <br /> ProfectName C�xbN WellNo yi/43 M ""J p2ta i/-/l- 47 <br /> ProfectNa Personnel <br /> GAUGING DATA <br /> Water Level Measuring Method Measuring Point Description �C%l <br /> Casing Tota[Req d <br /> WELL Total Depth Depth to Water I Water Column Multiplierfor Volume I Purge Volume <br />' VOLUME (feet) (feet) _ (feet) X <br /> � Casing Diameter <br /> (Sal) (gal) <br /> CALCULATION Q I 4 6 <br /> 0 1610 64 11 44 <br /> PURGING DATA <br /> Purge Method IA_CLL U VYI 2122-C-6 L K Purge Depth Purge Rate ` <br /> Time <br /> Volume Purges(gal) <br /> -Temperature(0 C) <br /> S ecrfic Conductive umhos f_ r' <br /> p �c �)- � 1_7+3 I 3'� Sr co <br /> -Odor <br />' =Casing lVolumesRemovedt <br /> TDewatered'7 " " <br /> C o m m e nts/Obse rvati a ns <br />' SAMPLING DATA Time Sampled 7 +fid Approx Depth to Water During Sampling C�_ <br /> Comments <br />' Volume Shipped Under Cham <br /> Sample Number of Container Filled of Custody at aoc Analysis <br /> Number Containers Type Preservative or t l Turbidity Color (YINMethod Comments <br /> Lll/4t„l,wl VDA FILL �-brntr tuw <br /> rTotal Purge Volume DisposalYContairtment Method TP-At CrE TTVALL C_ <br /> OwthereaConditions ��� <br /> Condition of Well Box and Casing a1Time of Sa ling <br /> Well Head Conditions Requiring Correction(locks,damaged casing orwell box,etc) 4%/6— h"4S�r <br /> Problems Encountered During Purging and Sampling <br /> Comments <br /> IPM5 PRQ1 TEMP FORMS PURGE tC96 <br />