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JL`C.[lLC ,(lyLf:1 1 LL.IyLVI,,u.o s..�•... <br /> WATER SAMPLE FIELD DATA SKEET <br /> PURGED BY WELL I D <br /> PROTECT# I( I{o00-- b '- <br /> 0A –O l SAMPLE I D . G <br /> SAMPLED BY-�`^�� <br /> CLIFSTr NAME RRA '�-�� C Q4 QA SAMPLES <br /> ON 110,11CD g } NO G ? <br /> Q START(2400111) <br /> ` �Q END(Z4p0Eir) <br /> DATE PURGED � <br /> DATE SAMPLED "� � � SAMPLE TIME(24001ir) �� 2 <br /> �/ <br /> Groundwater j Surface Water Treatment Effluent Other <br /> SAMPLE TYPE 5_� 6- Other <br /> 4_ 8' <br /> CASING DIAMETER 2" 3• 50) (2.60) ( ) <br /> Casing Volume (gallons per foot) <br /> (0 17) (0.38) {0 b7) (I.O2) ( <br /> l •rJ CASING VOLUME(gal) <br /> DEPTH TO BOTTOM(feet) <br /> . � CALCULATED PURGE(gal) = L <br /> DEPTH TO WATER(feet) <br /> WATER COLUMN HEIGHT(feu) ACTUAL PURGE(gal) <br /> FIELD MEASUREMENTS <br /> CONDUCTIVITY PH COLOR TURBIDITY <br /> DATE TIME VOLUME TEMP (Visual) <br /> (2400hr) (g� (degrees F) (umhoslcm) (�n�) (� – <br /> „SAMPLE INFORMATION SAMPLE TURBIDITY: <br /> SAMPLE DEPTH TO WATER. <br /> ' / <br /> 80% RECHARGE.V YES—NO ANALYSES <br /> p (J14S <br /> ODOR O L. SAMPLE VESSEL!PRESERVATIVE — <br /> PURGING EQUIPMENT SAMPLING EQUIPMENT <br /> Bladder Pump Bailer(Teflon) <br /> Bladder Pump Bailer(Tenon) Bailer( _PVC or disposable) <br /> Bailer(PVC) Centrifugal Pump <br /> Centrifugal Pump BSubmersible Pump Bailer(Stainless Steel) <br /> Submersible Pump Bailer(Stainless Steel) Dedicated <br /> Peristaltic Pump <br /> Dedicated Peristaltic Pump <br /> Other <br /> Other <br /> Pump Depth _ <br /> LOCiUf <br /> WELL INTEGRITY ,p�r) 5i <br /> REMARKS <br /> Page J— <br /> of f <br /> SIGNATURE <br />