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1 <br /> Date -Z 1/71-f: <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name: � cN 7 79uZ Well Number: � <br /> Project Number- r ��dLr� Personnel. <br /> 1 GAUGING DATA i <br /> t <br /> Water Level Measuring Method-,= Measuring Point Descnptton <br /> 1 Total Depth Depth To Water Water Column Multiplier For Casing Total Req a <br /> WELL (feet) (feet) (feet) Casing Diameter Volume Purge Volume <br /> VOLUME ,�, y _ (gal) (gal) <br /> 1 CALCULATION ? X 2 4 $ 7 <br /> ���d �r> 3• Gl 0.16 a 64 144 G <br /> 1 PURGING DATA <br /> Purge Method _ ����. vr /G Purge Depth _�c����- Purge Rate �S <br /> Time <br /> Volum Purged (gal)+ "`-. ;` �} 0 z• <br /> Temperature <br /> pH <br /> 5peafic Conductfvity(I mhos) , 7Z-� 7gO <br /> Turbidity I Cofer "' `- <br /> Odor =-- <br /> vi <br /> t. _33- <br />' }`J <br /> Casing Volumes Removed <br /> DewateredT }e,�,•r t <br /> _ Cj <br /> 1 Comments/Observations. <br /> SAMPLING DATA <br /> Time Sampled. . Approx Depth to Water During Sampling ; <br /> 1 Comments <br /> U"*.G2,.at _ _ - <br /> l�n,�;.r of Got><sleri , tM_ �-_ i aa4.t,.Fdl�d "-`�• ;.} _ Cuscdy M.lr.ts- <br /> l+` ft°r �++►s T" - Ptes�rv�ttti (ml or q Tu U&W Calor •ta'C(YfM Alwatod C4rnr" <br /> ip w <br /> I <br /> 1 Total Purge Volume z Disposal/Containment Method <br /> Weather Cana=Mons `L <br /> ondition of Well Boz and Casing at Time at Sampling r ii <br /> Well Head Conaiticns Requiring Correct,on (locks damaged casing or well box etc J — <br /> ProlDlems Enccunterej During Purging and Sampling <br /> Comments <br /> 1 <br />