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GROUNDWATER PURGE AND SAMPLE FORM Date:. Fe-b 23 "q3 <br /> Project Name: EXxo n �S ?"3 `-Z _ Well Number• <br /> Protect Number S373a h2 02-63 Personnel �32 <br /> GAUGING DATA <br /> Water Level Measuring Method- M"i&G _ P-0 hC Measuring Point Description T°L <br />' Total Depth Depth To Water Water Column Multiplier For Casing Total Req'd <br /> WELL (feet) (feet) (feet) Casing Diameter Volume Purge Volume <br /> VOLUME � _ �/ � (gal) (gal) <br /> CALCULATION � 2� 3 3•�Z � � 2 4 6 <br /> 0 16 064 144 <br /> PURGING DATA <br /> Purge Method Vacyym Tryc.1-1- Purge Depth F-:"t( Purge Rate"` <br /> ,,. ,fir m�`: �:• � <br /> T- <br /> -q6 <br /> 4 <br /> T Arl <br /> op <br /> pe dw�i <br /> Ttab <br /> Cas V6kiWi iI eco- <br /> N d <br /> Y <br /> Comments/Observations <br /> SAMPLING DATA Time Sampled. mou Ap rax Depth to Water During Sampling L 1 <br /> Comments: <br /> Seta 't�mtser�`' tenet; VQ<��Ftliad £'tisiad�C Rt�at��s, <br /> i+Erurst:ee r t r Type Pcesery aA+ (tel ar 1# i uFriidETg Ccrt'r g d' y1[3 HtemoQcommentT <br /> Vi-v- 3 vont 4d l�iod �� i3Yx <br /> TP 14 - <br /> tal Purge Volume. Disposal/Containment Method <br /> koeather <br /> Conditions hA""4cxS <br /> Condition of Well Box and Casing at Time of Sampling <br /> Well Head Conditions Requiring Correction (locks, I� <br /> damageq casing or well box, etc) c�C <br /> Problems Encountered During Purging and Sampling <br /> Comments <br />