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WELL MONITORINGIDEVELOPMENT <br />FIELD DATA SHEET <br />Client/ rr � <br />Facility CLev,,, ZI -S 77-�- Job#: 3 6 qbS. SS <br />Address. Date: <br />City. [-41 Sampler. <br />Well ID Well Condition <br />Well Diameter Hydrocarbon Amount Bailed <br />Total Depth ft. <br />Depth to Water �3 • ft. <br />hickness Ft. iproduct/water) (nal <br />Volume 2" - 0 17 3" - 038 4" = 0 66 <br />Factor (VF) 6" - 1.50 12" = 5 80 <br />X VF - X 10 (case volume) = Estimated Purge Volume — (oal.) <br />Purge <br />Disposable Bailer <br />Sampling <br />Equipment <br />Bader <br />Equipment- <br />Disposable Bailer <br />Stack <br />Bailer <br />Suction <br />Pressure Bailer <br />Grundfos <br />Grab Sample <br />Other <br />Other <br />Starting Time <br />Weather Conditions <br />Sampling Time <br />Water Color <br />Odor <br />Purging Flow Rate <br />_ aom. <br />Sediment Description <br />Did well de -water? <br />If yes, Time <br />Volume <br />Time Volume pH <br />Conductivity Temperature <br />D O ORP Alkalinity <br />(gal ) <br />µmhoVcm "C <br />(mg/L) (mV) (Ppm) <br />LABORATORY INFORMATION <br />SAMPLE ID (x) - CONTAINER REFRIG PRESERV TYPE LABORATORY ANALYSES <br />COMMENTS t5 W4 W aS 5a" d 1611 16 9 <br />ry CL5 5 v� w, ` v.PSear sc p o � CO c- <br />1� <br />• <br />• <br />• <br />