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- <br /> GROUNDWATER PURGE AND SAMPLE FORM Date <br /> Project Name ZE��n/ Well Number <br /> Project Number Personnel <br /> GAUGING DATA <br /> Water Level Measuring Method Measuring Point Description <br /> Total Depth Depth To Water Water Column Multiplier For :Casing Total Req dolume Pure Volume <br /> WELL (feet) (feet) (feet) Casing DiametgVOLUME a� Xgal) (gal) <br /> CALCULATION rt n �� � A 2 � <br /> 7`T 016 0 11444�•� <br />' PURGING DATA <br /> Purge Method !/ Purge Depth Purge Rate <br /> Tfma <br /> Volume Purged (gall <br /> Ternper=re{11,C) <br /> PH <br /> Speiili�_- �cvrilyjj.=tcsl- // J <br /> Turbo#Color ` <br />' basinq Vaturnas Removed ) 3 5'Z <br /> Dewatered7 n �/ <br /> Comments/Observations <br /> SSAMPLING DATA Time Sampled ped Approx Depth to Water During Sampling <br /> Comments <br /> s`t�ppecf urFdea caatn ar � <br /> sampGa Numharot 4COnt Ener V {^Flied <br /> Gustnd� Arrafysis <br /> N=ber Cur�r+ers I 'rya AiesewaWe 4 1 !} TV t»dity Cafar a>;4C4Y1N} Methoo 07;lwh <br /> t1 <br />� 1 <br /> Total Purge Volume Disposal/Containment Method <br /> ather Condittons <br /> ondition of Well Box and Casing at Time of Samplingi�_ <br /> Well Head Conditions Requiring Correction (locks, damaged casing or well box, etc) <br /> Problems Encountered During Purging and Sampling 1'1� <br /> Comments <br />