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Date. <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> Project Name X 2 . Well Number 1p _ <br /> Protect Number- �7.��y,Z -«ZG3 Personnel _ <br /> GAUGING DATA <br /> Water Level Measuring Method Measuring Point Description <br />' Total Depth Depth To Water Water Column Multiplier For Casing LTotaReqd <br /> WELL (feet} (feet) Volume(feet) Casing DiameterVOLUME .^ — V (ga <br />' CALCULATION L�J `t ! ��� / r �` J` 0 64 144 <br /> U fi r <br /> PURGING DATA <br />' Purge Method Purge Depth 224�� Purge Rate <br /> Tfmia <br />' votume Purged{gad <br /> Tertxer4uie�°C) <br /> PH <br />' Specit�C4DnductWitp has)' <br /> TL,rbid r t G0far <br /> , <br />' ~Casing Voitumes R__r»�red <br /> ADeeredj r n <br />' Comments/Observations <br /> SAMPLING DATA <br /> Time Sampled Approx Depth to Water During Sampling <br /> Comments <br /> sasrmpre` Nu i3erar Czntatner• e A s n v J Sf3sppadurrearCti�drmnt _ n <br /> Number, <br /> ,' t�rmers T� Pteservafmve #iriE 1} 3ut�+ditg= Chive" < i�t�E�re} � <br /> cr 41-6 <br /> L=I=t <br />'Total Purge Volume Disposal/Containment Method <br /> ather Conditions <br /> ddian of Well Box and Casing at Time of Sampling -_&e-e-c(S in <br /> Well Head Conditions Requiring Correction (locks, damaged casing or well box, etc ) :kt <br /> Problems Encountered Dunng Purging and Sampling <br /> Comments —_ _— <br />