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GROUNDWATER PURGE AND SAMPLE FORM Date - <br /> Project Name ��c�N _ Well Number <br /> Project Number- 5'T73,�ZZ '"02=G3 Personnel A�Z <br /> GAUGING DATA <br /> Water Level Measuring Methodeg-ffil,Z Qai—CZQ Measuring Point Description <br />' <br /> Total DCasing Total Req'd <br /> Depth Depth To Water Water Column Multiplier For Volume Purge Volume <br /> WELL (feet) (feet) (fest) Casing Diameter <br /> {gal} (gal) <br /> VOLUME .r <br /> CALCULATION 2 4 6 I <br /> t 064 144 r 5 <br />' PURGING DATAPurge Method �Z� Purge Depth Purge Rate <br /> Time <br />' <1fv€u d:pu i�d " / <br /> pr�r r n 5 <br /> S <br />' Cas�tg��(u��R.errtnv�d n zi � tJ <br /> Dewatere / l'✓ <br /> Comments/Observations <br />' SAMPLING DATA Time Sampled Approx Depth to Water Dunng Sampling <br /> Comments <br /> f san,pta frisirat, ,'citatner v va tct�ed vsrrr��aot r r <br /> `t iry <br /> ' }t.CT{t}CS r f7Bf5 „'t� `PIE"BIV8�K8 ryf15I(Sd r �2'�•I SiS.. ` ' `}t` } <br /> yPe tfnE i} ut id>FY C"afaF, 944C4YO Me*naod < riv i s enEsi+, <br /> zl ��- <br /> i <br /> I <br /> ITotal Purge Volume Disposal/Containment Method �rv.�o�.�iTC <br /> Pather Conditions D <br /> n6tion of Well Box and Casing at Time of Sampling _ <br /> ll Head Conditions Requiring Correction (locks, damaged casing or well box, etc) <br /> Problems Encountered During Purging and Sampling <br /> Comments <br />