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lam <br /> Oeste yZ�/ / r <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> CPr:cc)jeC:tNa7me- ' !� 7 794/7 WellNumber- Zer- 4rr� ,zJ, -� Personnel /-/ / 4a,-! _ <br />' GAUGING DATA <br /> Water Leve! Measuring Meittod.�-N/—• r- "err /,+ Measuring Point Oescnption• To �c'C�s11,N <br />' Total Depth Depth To Water Water Column Multiplier For Casing Tota! Req <br /> WELL (feet) (feet) (feet) Casing Diameter Volume Purge Volume <br /> VOLUME~ y (gal) (gal) <br />' CALCULATION A � 4 S -� <br /> r 16 4 I , " c.(� <br />' PURGING DATA <br /> Purge Method Purge Depth c Purge Rate <br /> Time <br /> Volume P <br /> urged (gal}" �{ - <br /> Temperature <br /> .�6 c <br /> 4.1 <br /> pH ;_. , <br /> Y? � � <br /> ry' , <br /> Spectftc Conducttvtty.-(µmf�os) flD <br /> Turbidity/Color `r�„- �' , L•w <br /> Odor <br />' - Castng Volumes Removed ~ r <br /> Dewatered? .- ►n., ` 6 , <br />' Cnmments/Observations <br />' SAMPLING DATA <br /> Time Sampled 3 . Approx Depth to Water During Sampling <br /> Comments _ _ _ <br /> 5arnn+s li�ar+oar 01 Car+tala+�r -�` * Vahan FcMd --,� �P��+l�l��n,.a,�,s,�r yAnaty— <br /> GTtbn of <br /> C.ars>inw= T�rpr Praarvealra (m1 ar Q Ttseefdty color at s'C{Y" hbwwwd QnTwr a.0 <br /> F'i <br /> Total Purge VolumeDisposal/Containment Me+nod T �'c ^ �� <br /> Bather Conditions c�L <br /> onaition of Well Box ana Casing at Time of Samos:ng — <br /> Well Head Conant ins Pecu,rsng Carre:on (locks damaged casing or well tox etc <br /> Prca;er^s Enccun•erea OLrsng Purging ana Sarrpling Cor—encs ?.z <br />