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1 <br /> ETIC ENGINEERING <br /> GROUNDWATER PURGE AND SAMPLE FORM <br /> ProjectName. Well No �Ill�l!/,2ate q <br /> Project No- �{� . / Personnel: <br />' _ ._ <br /> GAUGING DATA <br />' Water Level Measuring Method: (Aif!Q Ct Measuring Point Description*, TJD <br /> Casing Total Req'd <br /> WELL Total Depth Depth to Water Water Column Multlplierfor Volume Purge Volume <br />' VOLUME (feet) t..� (feet) (feet) X Casing Diameter (g�) — (gal) <br /> CALCULATION r� 2 6 <br />' 0 16 064 1.44 <br /> PURGING DATA� <br />' Purge Method _V _ � _ _ Purge Depth Purge Rate. <br /> Time �' i u5q t05 job <br />' Volume Purges(gal) [ <br /> Temperature(11c)-., ;- ` ;�r � S � �•� t � 1 <br /> pH 'J qq <br /> SpecificConductivity(umhos) <br /> Turbidity/Color <br /> Odor <br /> Casing Volumes Removed� � <br /> Dewatered? <br /> IComments/Observations <br /> SAMPLING DATA Time Sampled J u �r <br /> p Approx Depth to Water During Sampling _ <br /> Comments <br /> volume � r Shipped Under Chain <br /> Sample Number of Container Fitted _` °"gin of Custody at 4aC Analysts <br /> Number Containers Type Preservative mL or L Turbidity Color 4 Method y Comments <br /> Total Purge Volume Patti DlsposallContatnmertiMethod <br /> Weather Condittons SLx-ZV <br /> Condition of Well Box and Casing atTime o Sampling. <br /> Well Head Conditions requiring Correction(locks,damaged casing Orwell box,etc) <br /> Problems Encountered During Purging and Sampling kip <br /> Comments <br />