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' ETIC ENGINEERING <br /> ' GROUND <br /> WATER PURGE AND SAMPLE FORM <br />' Pro)ectName C /(XQ V Well No—mw V ate <br /> . Pro)ectNo 'A� . / Personnel: ��" <br />' GAUGING DATA <br />' Water Level Measuring Method:, 1l1-CYQUZ-0416 Measuring PointIDescnption: :fD:C . :t:�- <br /> Gastng Total Req-d <br /> WELL TotalDepth Depth to Water Water Column Mutdplterfor Volume PurgeVolurne <br /> 2 n4 6 L4 <br />' VOLUME (feet) (feet) — (feet) X Casing Diameter (gal) (gal) <br /> CALCULATION "" <br /> LO <br /> 0 16 064 144 <br /> PURGING DATA t <br /> Purge Method 1� T1 Purge Depth- Purge Rate.'-��Qrn' <br /> Time 1q0 11-4 L 11 qq W/0 <br /> /y� 0 <br /> Volume Purges(gal) <br /> Temperature(°C) <br /> Specific Conductivity(umhos) <br /> Turbidtty/Color t�� <br /> 6 <br /> Odor <br /> �Casing Volumes Remvwed . <br /> Dewatered? <br /> s <br /> Comments Observations <br /> SAMPLING DATA I �C'Time Sampled �I- �- Approx Depth to Water During Sampling <br /> Comments <br /> I Volume Shipped Under Chain <br /> sample Number of Container Filled L ``# 3 of Custody at 4°C Analysis <br /> Number Containers Type Preservative (ml_or I-) Turmity, Color , ;Method comments <br /> . Total Purge Volume Disposal/Contamment Method ltlKq <br /> Weather ConditionsSIJTI!2�3 1i <br /> Condition of Well Bax and Casing atTirrie of Sampling <br /> Well Head Condittons Requiring Correction(locks,damaged casing orwell box,etc) f7 <br /> Problems Encountered Dunng Purging and Sampling V1 0 <br /> Comments <br />