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t- <br /> 14�m — GROUNDWATER PURGE AND SAMPLE FORM Date <br /> Project Name Well Number 4,1 L--,C <br /> Project Number Personnel <br />' GAUGING DATA <br /> Water Level Measuring Method '•• Measuring Point Description - -�2 (Gc G i <br />' TcasingTotal Oepth Depth To Water Water Column Multiplier Far Tatal Aeq b i <br /> WELL (teat) �� (feet) (feet) Casing Diameteme Purge aolurrei <br /> VOLUME v (9 ) <br /> CALCULATIc �7 �( IA 2q q 317�p lU �f 016 I Qsa � l � �D <br />' PURGING DATA > ' <br /> Purge Method , 77-7r /G <br /> - r Purge Depot c �� Purge Rate <br /> ume Purged (gal)+ <br />' Temperature <br /> PH <br /> Specific ConducttvW(wrthos) <br /> Turbidity/Caior Y',` - <br /> - ;_ [•dc,si O LIL <br /> a i <br /> Odor — <br /> #1 ! <br />' Casing Volumes Removed <br /> ' 1 <br /> Comments/Observations <br /> SAMPLING DATA Time Sampled i <br /> Approx Depth to Water During Sampling + <br />' Comments - r I <br /> UrvIS Maroer of eomLbn.r .1C�r <br /> _ lshwpw under Q1axr C11 -- <br /> i+iurnow caKrt "we 7 `--"�rN+ (mi r Vot(" Ffor 1}ti.e } _ - C—&f ArdUV*r <br /> Y9+ 7urt>h£ry x <br /> at 4'C(7lNt "Mtttad COMM"" <br />' Total Purge Volume <br /> DisposaVContainment Metnod <br /> eather Conaltions <br /> cnoition of Weil Box and Casing at Time of Samoting i <br /> Well Head Cons • ons Pecuiring Correc-on (lacks darraged casing or we l Cax etc ) <br /> P"onlerns E^ccun e-4�3 D.rnng P--rg,ng and Sarro,ing <br />