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Rev, 5J96 <br /> WATER SAMPLE FIELD DATA SHEET <br /> PROJECT NO: SAMPLE ID : <br /> PURGED BY: CLIENT NAME : <br /> SAMPLED BY: LOCATION! <br /> TYPE: Groundwater Surface Water Leachate Other <br /> CASING DIAMETER(inches): 2 3 4 4.5 6 Other <br /> CASING ELEVATION(feet/MSL): VOLUME IN CASING(gal.) : <br /> DEPTH OF WELL(feet) : CALCULATED PURGE(gal.): <br /> DEPTH OF WATER(feet): ACTUAL PURGE VOL.(gal.) : <br /> DATE PURGED : END PURGE: <br /> DATE SAMPLED : SAMPLING TIME <br /> TIME VOLUME pH E.C. TEMPERATURE TURBIDITY TIME <br /> (2400 HR) (gal.) (units) (lctrdtos/om@25°c) (°) (visual/NM) (2400 HR) <br /> wOTI IER: ODOR: <br /> (COBALTO-100) (NIU 0-200) <br /> FIELD QC SAMPLES COLLECTED AT THIS WELL(i.e.1713-1,XDUP-1) <br /> PURGING EQUIPMENT SAMPLING EOUIPMENT <br /> 2"Bladder Pump Bailer(Teflon) 2"Bladder Pump Bailer(Teflon) <br /> Centrifugal Pump Bailer(PVC) Bomb sampler Bailer(Stainless Steel) <br /> Submersible Pump Bailer(Stainless Steel) Dipper Submersible Pump <br /> Well Wizard'" Dedicated Well WizardDedicated <br /> Other: Other: <br /> WELL INTEGRITY: LOCK: <br /> REMARKS: <br /> pH,E.C.,Temp.Meter Calibration: Date: Time: Meter Serial No.: <br /> E.C. 1000 / pH? / pH 10 1 pH 4 1 <br /> Temperature°F <br /> N <br /> SIGNATURE: REVIEWED BY: PAGE OF <br /> FIGURE <br /> INTERNATIONAL <br /> TECHNOLOGY WATER SAMPLE FIELD DATA SHEET A-2 <br /> CORPORATION <br />