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WATER SAMPLE FIELD DATA SHEET Rev, 5/96 <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 PURGF.: <br /> DATE SAMPLED: SAMPLING TIME: <br /> TIME VOLUME PH E.C. TEMPERATURE TURBIDITY TIME <br /> (2400 HR) (gal.) (units} (µmhos/cm(?P25°c) (°F) (visuaVNTU) (2406 HR) <br /> OTHER: ODOR: <br /> (COBALTO-100) (NTo a-zoo) <br /> FIELD QC SAMPLES COLLECTED AT THIS WELL(i.e.FB-1,XDUP-1) : <br /> PURGING EQUIPMENT SAMPLING EQUIPMENT <br /> 2"Bladder Pump Bailer(Teflon) 2"$ladder 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 Wizard'" Dedicated <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 1 pH 7 I pH 10 / pH 4 / <br /> Temperature"F <br /> SIGNATURE: REVIEWED BY: PAGE OF <br /> FIGURE <br /> . INTERNATIONAL <br /> TECHNOLOGY WATER SAMPLE FIELD DATA SHEET A"z <br /> CORPORATION <br />