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GROUNDWATER PURGE AND SAMPLE FORM Date: <br /> Project Name x z— Well Number <br /> WL—Prolect Number Personnel G.G5� G P <br /> GAUGING DATA <br /> Water Level Measuring Method C Measuring Point Description <br /> Depth Depth To Water Water Column Multiplier For Casing Total Reg <br /> Total De d <br /> P P P Volume Purge Volume <br /> WELL (feet) (feet) (feet) Casing Diameter (gal} (gal) <br /> VOLUME — <br /> CALCULATION 7 — 2 <br /> � <br /> 016 064 144 <br /> PURGING DATA <br /> 1 / <br /> Purge Method l/uc-uu -77-i/c_I4-- _ __ Purge Depths r T-_r1— Purge Rate-3'�o --- <br /> Ig <br /> �{ <br /> tTlrrle}`t G} v CY {{> 6A}Fry}v{L ?Y"'U`C of <br /> ! ^ <br /> Y{v f�W{s 3 ,}x'4 va rM xn h�x <br /> "Sear.�ii3YtCfL3Ctt�Ft���7��5'�';#f <br /> } CiT�7 f 103 { <br /> iY Nom'<}C��'h�n':vfi'i� �`�h'k.3�f�`}�nb�••}S o>,° <br /> 7 A.a w �{ rctm'irqbabnE } .�ax'�^^o-^2• cE ` <br /> c�5 vias <br /> ��;...°'^ ..... xc70�<�77,.kk`A;%t°�.f�f"r�rh`F <br /> >Z e <br /> a, o t..,e` 3m,',',`•v`,cr�,�::pr``^SJs�,TdS� �;�''��' t~n <br /> Co mments/Observations <br /> SAMPLING DATA Time Sampled Approx Depth to Water During Sampling <br /> Comments <br /> n�. ur�tti.:v>�-�w.,-..:�4�M S rT}•� {f�^Y`�i�.S{Y Sii3ii�fF�" ��j„+%,. 'i3>y3',{i? e,. {,, "x°"s�"x S <br /> Y 4Fk¢ .G c3.^,.',wa<c<iK�e b': ar., 4' .ca. <br /> ,,fes"' c .#i-'++,v.,.„.f�..tt ��?CC--? 'E �,,,{{ma�c C 4^$' L r^t, c> ]rpt. n ^^�.�F,r ay "�r ,.,C'w,wk. rr f ^T'ktrt•"g-,• <br /> o Sam*, $`j4(jRgbp( ,[a r^�taam �'ct� c'.'”,y„-h+y 5 ;ke r`?„x'«3 rr yw£cw7 A r t <br /> 4*�'*�F� c �C {f ,e..a <br /> FOO <br /> Total Purge Volume Disposal/COf ontainment Method �S'a,/t ,.. oK .r� <br /> Weather Conditions S --- <br /> Condition of Well Box and Casing at Time of Sampling +� <br /> Well Head Conditions Requiring Correction (locks,damaged casing or well box,etc) o , <br /> Problems Encountered During Purging and Sampling &a.. <br /> Comments <br /> 1 � <br />