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WATER SAMPLE FIELD DATA SHEET Rev. 5/96 <br /> PROJECT NO: SAMPLE ID : <br /> PURGED BY: CLIENT NAME: <br /> O YY [ 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) : ACI-UAL PURGE VOL.(gal.) : <br /> DATE PURGED: ENDPURGE: <br /> DA'T'E SAMPLED: SAMPLING TIME: <br /> TIME VOLUME pH E.C. TEMPERATURE TURBIDITY TIME <br /> (2400 HR) (gal.) (units) (limhos/cm@25°c) (IF) (visual/NTU) (2400 FIR) <br /> OTHER: ODOR: <br /> (COBALTO-100) (N-[U 0-200) <br /> FIELD QC SAMPLES COLLEC'T'ED AT THIS WELL(i.e.FB-I,XDUP-1): <br /> PURGING EQUIPMENT SAMPLING EQUIPMENT <br /> 2"Bladder Pump Bailer(Teflon) 2"Bladder Pump Bailer(Teflon) <br /> Centrifugal Pump )Jailer(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 / pH 10 / p114 / <br /> Temperature IF <br /> SIGNATURE- REVIEWED BY: PAGE OF <br /> L(Q*N FIGURE <br /> EMCON WATER SAMPLE FIELD DATA SHEET <br /> A-2 <br />