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' TIC ENGINEERING G GROUNDWATER PURGE AND SAMPLE FORM <br /> Pro)ectName C XXoAl WeliNo.-wate <br /> Pro,ectNo- Personnel: <br /> 1 <br /> GAUGING DATA <br />' Water Level Measuring Method:, ��CrCR� Measuring Paint Description', <br /> Total De th De thtoWater WaterColumn 4Casing <br /> or Casing Total plum <br /> WELL P P Volume PurgeVafurne <br />' VOLUME (feet) (feet) (feet) X eter (gam (g4 <br /> CALCULATION .. o 144 153 <br /> PURGING DATA <br /> Purge Method Purge Depth. Purge Rate <br /> Time q p!5 RU, -t j r NqVolumePurges(gal) <br />' <br /> �� r19.9 Temperature(°C) - <br /> ,F -�f,'<x-., <br /> PH <br /> ISpecdic Conductivity(umhos) <br /> Turbidity/Color V <br /> Odor _;N- z" <br /> g ,.,�,_ tucd <br /> ',Casing Volumes'Removed �::ti <br /> _ a <br /> Dewatered'? <br /> Comments/Observations <br /> ISAMPLING DATA Time Sampled Approx Depth to Water During Sampling [ <br /> Comments <br /> Volume �, Shipped Under Chain <br /> Sample Number a! Container Filled r %�+�"� d custody at a°C Analysis <br /> Number Containers Type Preservative mL or L Turbidity Color -Method Comments <br /> OL <br /> ff __ <br /> Total Purge Volume lS� Qa�l DisposaUContainmentNethod l g OKI <br /> I Weather Conditions <br /> Condition of Well Box and Casing atTime f Sampling <br /> Well Head Conditions Requiring Correction(locks,darnaged casing orwell box,etc) <br /> Problems Encountered During Purging and Sampling <br /> Comments <br />