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' MY-16-19% 15.40 EA NORTH SACRRMENTO 1 916 924 '7460 P 16/17 <br /> En <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> 7 <br /> Protect Name Well Number !� <br />' Project Number Personnel <br /> GAUGING DATA <br /> Water Level Measunng Method Measuring Point Description <br /> Casing Total Req d <br /> WELL Total Depth Depth to Water water Column Multiplier for Volume Purge Volume <br />' VOLUME (feet} (feet) _ (feet} X Cas2l !=etar (gal) _ aq <br /> CALCULATION J q Hi . <br /> _.� � 0 78 <br />' PURGING DATA <br />' Purge Method Purge Depth f Purge pate <br /> Time <br /> Volume Purges(gal) 0 - g <br />' Temperature(DC) 1 <br /> pH <br /> Specific Conductvrty(urnhos) <br /> Turbidity I Color d <br /> r6r..4, <br /> Odor GT f� Li(� L [� L <br />' Casing Volumes Removed } <br /> Dewatered? <br />' Comments I Observation <br />' SAMPLING DATA ! <br /> Time Sampled Approz Depth to Water During Sampling <br /> Comments <br /> Semple NUT41oral Cant urter FiledVolume Sn�pQea Under Cham of <br /> AAdty3�9 <br /> NuMer Containers f y9& Preservatrva mTumwiny Cnior at'm M I Meftd Comments <br /> �ry �---- <br />' Total Purge Volume, DlsposaUCantalnment Method <br /> Weather Conditions <br />' Condition of Well Box and Casing at Time of Sampling <br /> Well Head Conditions Roquinng Correcvon (locks, darinaged casing or well box e[c) <br /> Problems Encou eyed Dunng Purging and Sampling <br /> Comments <br /> PMAPRW TMP.PuW-et2P4 <br /> 1 <br />