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GROUNDWATER PURGE AND SAMPLE FORM Date
<br /> Project Name ,,_,,Ai 7— 2yi= __-- Well Number-
<br /> Project Number Personnel
<br />' GAUGING DATA
<br /> Water Level Measuring Method C �4 crz_ Measuring Point Description ��'—
<br />' Total Depth Depth To Water Water Column Multiplier For
<br /> casing Total Req d
<br /> WELL (feet) (feet) (feet) Casing Diameter
<br /> Volume Furge Volume
<br /> VOLUME (gal} (gal)
<br /> CALCULATION _ 4 6
<br />' Gf��
<br /> 01 064 1 4a Z . D 5
<br /> PURGING DATA
<br />' Purge Method �G v viz , el 1L Purge Depth Purge Rate
<br /> Td--}rte rattir °C j v "]
<br /> _7�[[�� rS�x�.q�•�s�v��v
<br /> 3 E+ S }
<br /> f_"'iJn
<br />' '.,� tic`mg�g'y+ry},+asi tducs r�t)CA scr�hos
<br /> MA
<br /> fr+s•,,,{srath
<br /> tel
<br /> ���t2�r`4 {sh
<br /> 411,111
<br /> Comments/Observations ,- 5 -r �G L
<br /> SAMPLING DATA Time Sampled. Approx Depth to Water During Sampling-
<br /> Comments
<br /> tsu,k f[� ]X t �e�'.aL fn�-ktw�{{v,+$,Ycuj�l�' }�y :,r r'h 3,•i'+g"" y+] + .� ,� �04�{.a- r owh
<br /> AG�^'r+^.."
<br /> ,.fi Sror,Ywx nca�.r,Ep.�.]xo..,�,..a++�.no eon M cwG.Vw�+s .s,,,W �.�Y]v o�`,xv ,.rrj%�!}4< o yQ� y_ ��.S4Sdr �{ r,,,,�++3 •w r{ rY
<br /> SY,Y,rc
<br /> ] 1�',;'� � w]?,e�ee£.w+`�n� y.,.{i} {�.3'.i�'Ywxct�e}{•{r� �Al'�,�fi„� zr. tet° i.+ `L3`'�hw r�}x, t�:,�v �tSSS °S' h d'" � r,�:y s'y{,
<br /> A�o�e�}��� ++�" ,,yy �.}�r {!��r 4?i .�✓�� .fr].+ 4 1`E Fx+}I i,v-.`fp r 3
<br /> �}•�`•^^r�Y9{[ltW. ++q}
<br /> +iwA YM
<br /> Total Purge Volume Disposal/Containment Method , r£
<br /> 6 Weather Conditions
<br /> Condition of Well Box and Casing at Time of Samp
<br /> Well Head Conditions Requiring Correction (locks, danma casing ar well box,etc) dL���./C �r� .�aG�L_ tC IZ
<br /> Problems Encountered During Purging and SamplingComments
<br /> r
<br /> 1
<br />
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