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GROUNDWATER PURGE AND SAMPLE FORM Date- <br /> 7 <br /> ate- <br /> Am - <br /> FProject Name. �� 7 7917 Weil Number- <br /> ject Number ,L �-9«Z i?a <br />' Personnel- <br /> GAUGING DATA <br /> Water Leve! Measuring Method��t.. - Measunng Point Descnp#ton-_To c7 C7 tAC- <br />' Tota! Depth Depth To Water sing Total Req <br /> WELL l' Water Column Mulilpller F;Iial) <br /> � <br /> (feet) (feet) (feet) Casing Diaume Purge Volume <br /> VOLUME; _ v (ga') <br /> CALCUL nON 7� 7r A1 4Q� <br /> LIJ '� / ���z ��J 0.16 0 64 f 144 Z. L7 <br />' PURGING DATA <br /> Purge Method: Purge Depth: Purge Rate <br />' Time <br /> VolumePu <br /> rged (gal)+ 3 tv <br />' Temperature (oq, <br /> pH <br /> Specific Co-n­d"U'CttV1t-Y-7(-1L'-Mh-os) <br /> R <br /> Turbidity/Cnloc �' =�;:_';.: �' 1....- <br /> .,- <br /> Odor ,; , ,� <br /> • ��.. y .. <br /> Casing Volumes Removed _= � � <br /> ri�rtY,:t <br /> Dewatered7 3 <br /> Comm ents/Observaitons <br /> ISAMPLING DATA <br /> Time Sampled. _ Approx Depth to Water During Sampling <br /> Comments, - Y <br /> 5a�pls N�+a.r of Conahrr :_. _ 7:,- Shppae UndW chwe et <br /> Ca„i�l,tiwt tp+�.ev�ttwT VChOM Fill" <br /> IVurr°°" Typr (nM or(} 'rurtfsy color at arc/M 144111010d Cornm:rta <br /> Total Purge Volume Disposal/Containment Method %1«c ^e C 1r' <br /> Weather Cartaitions vtz=:� <br /> ancition of Well Boz and Casing at Time of Sampling- <br /> Well Head Conditions Recurring Correct an (locks damaged casing or well box, etc 1 Problems Encountereo During Purging and Sampling <br /> Comments <br />