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Purge Loa Form <br /> Oqj=Name A C s Froject Number ° c) 36'A' Site Location � ^ <br /> well No L4 Date p3 l 3 p 1 oef1 <br /> Fi:'d Teat c <br /> Taal Depth 4Q G <br /> Depth to water `�S $Q Wa►_ y <br /> P cr ColLriz L,.ngLr <br /> Casing Dtametc:-_ y Casing Factor Volurre Calcislaucia <br /> Total Purgc Volu.-nc Casing vclumes Froduccd -3 Pumz Type 6 <br /> PH Meter Caltcrated (ykr Cond Mcler EM Calibrate -Y, r,; <br /> Te•np Nfe,er WILL t. Turotd,nhie'e:_tel _ CaItarated �c or Iv <br /> [Cz,,,g Factor V= 27 3"=38 4"= 66 5"=1 02 6"=c 5 S"=Z 6 (In Gallons pe-ir:car fcat)] <br /> T'ne —Prod Rate Gallons' <br /> tatal) DTW Ph Fc Te--c ('C) Tumid.,t-a Carn.-nent_s <br /> O9 So 1 -3 S- .1s S o f 6S'.a I AA C <br /> boo 3 . -4 d <br /> -?3-11pL <br /> S0 � 6 � 01 <br /> Stcrzgc or Disposal 1`i--thod SS Tofai Drams Orstte <br /> P:rc.�t Rcc:targe Pn"to Sampling loot Samplc Collection Nfc:hcd 1�P� • <br /> sample I-3bered Sam lc Time 31s' <br /> P � Labarator. <br /> Analysts /3�e� }Y1, No o(Containe-s �— <br /> DapIirste Tnp Blank Rtnsate Blank <br /> Comments 1 <br /> L U C,< <br />