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' ETIC ENGINEERING <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> 1Prme C �xQ� Well No � ate -5- _- <br /> � "C <br /> a[Pro:jectN7o <br /> , / Personnel. <br />' GAUGING DATA <br /> 1 Water Level Measuring Method: f�ok�6 __ Measuring Point Description: T0t—,-- <br /> Casing Totat Req'd L <br /> WELL Total Depth Depth to Water Water Column Muttlplierfor Volume AurgeVafume <br />' VOLUME (feet) (feet) (feet) X Casing Diameter (gal) _ (gA <br /> CALCULATION a �� 2 6 <br /> PURGING DATA 1 144 <br /> Purge Method Purge Depth Purge Rate td -7,7 <br /> Time ! qt 5 j . 1Dq <br /> s $ jq `! i / ra� <br /> VolumePurge (gal) a _>' ! /, �V q Q 1 1�� <br /> Tempe rature(°C) .: s _-.R,..;,_ -"t --5 <br /> SpectllcConductivdy(umhos) -7q 1 „ —75 <br /> • Turbidity/Color <br /> Odor <br /> sCasing Volumes Removed <br /> Dewatered? <br /> r, <br /> Comments/Observations <br /> I <br /> SAMPLING DATA Time Sampled 1 Approx Depth to Water During Sampling 1J <br /> Comments <br /> Volume Shopped Under Cham ti <br /> Sample Number of Container Filled rL of Custody at 41C Analysis <br /> Number Containers Type Preservative m!_or l ` rutbidity Calor t _Method Comments <br /> Total Purge volume Disposal/Containment Method <br /> Weather Conditions upcCkn 'i <br /> Condition of Well Box and Cascng atTim of Sampling <br /> Well Head Conditions Requiring Correction(locks,damaged c ing orwell box,etc) <br /> Problems Encountered During Purging and Sampling <br /> Comments <br />