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Date z <br /> GROUNDWATER PURGE AND SAMPLE FORM a' <br />' Project NameWell Number In ' <br /> Project Number 5�373f ZZ -a�63 . Personnel <br /> GAUGING DATA <br /> Water Level Measuring MethodMeasuring Point Descnption <br />' sing Total Req'd <br /> Total Depth Depth To Water Water Column M3. 1440 <br /> r <br /> ume Purge Volume <br /> WELL (feet) (feet) (feet) Casteral) (gal) <br /> VOLUME CALCULATION JL26� �� J� l 0 i6 (�-- 11W 7 <br />' <br /> PURGING DATA <br /> Purge Method !�� Purge Depth / 11�-�l�!-- Purge Rafe <br /> S ~ <br /> Time -ZA ad v <br /> ernperatwre <br /> PHA. { <br /> Turbi 1,C0F4c` <br /> c5 } �rAau 1.3 Z Z C <br /> Dewafered? <br /> Comments/Observations <br /> ISAMPLING DATA Time Sampled Approx Depth to Water During Sampling <br /> Comments <br /> S=Pia Numbat of 1'"n" V 8xect Pad t�rEder car e y v <br /> is v <br /> 1�httsbex Cor��ers„�` `7'.yt�< j#'resen%atnre .#�! 1� 4�iatnidriY. -C�r. •ate C�Y�t`� ;A�hoG;• s�M s�t,�v <br /> Y �� <br /> I , <br /> I <br />� I I <br /> Total Purge Volume G�v� _ Disposal/Containment Method siT <br /> ather Conddions <br /> dition of Well Box and Casing at Time of Sampling <br /> Well Head Conditions Requiring Correction (locks damaged casing or well box, etc ) h� <br /> Problems Encountered During Purging and Sampling <br /> Comments <br />