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' ETIC ENGINEERING <br /> GROUNDWATER PURGE AND SAMPLE FORM <br />' Project Name C XXd!V Well No P)gw jqate <br /> • Project No �� , / Personnel: <br />' GAUGING DATA <br />' Water Level Measuring Method Measuring Point Description- <br /> casing Total Req`d <br /> WELL Total"DepthtoWater Column Multiplierfor Volume purgeVolume <br /> VOLUME; (fe (feet) X CasingDiameter (gal) (gal) <br /> CALCULATION � I. �Z 2 4 f3 W -39 �. <br />' Lv fl 16 0 f4 11-44 <br /> PURGING DATA <br />' Purge Method Purge Depth Purge Rate rrl-' <br /> Time 2� j 3�C" <br /> Volume Purges(gal) <br /> Temperature(°C) <br /> pH <br /> Specific Conductivity(umbos) .. '7 5 y •73 <br /> Turbidity/Color <br /> Odor `ar._- - V �l /\J fi <br /> Casing Vo[umes'Removed�� { Q Q,A f ,R 2 () <br /> t ' <br /> Dewatered9 g �* <br /> x <br /> Continents/Observations <br /> SAMPLINGDATA Time pprox Sampled f3�� A t <br /> p � Depth to Water During Sampling <br /> Comments <br /> Volume •, Shipped Under Chain <br /> Sample Number of Container Filled-be of Custody at 4°C Ar►alysis <br /> Numr Containers Type Preservative mL or! Turbidity Color 4' ,Method Comments <br /> I - ai Srf� <br /> Total Purge Volume Disposal/Containment Method <br /> Weather Conditions <br /> Condition of Well Box and Casing at Time of Sampling <br /> Weil Head Conditions Requiring Correction(locks,damaged casing or well box,etc) <br /> P roblems Encountered D unng Purgi ng and Sampling <br /> IComments <br />