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WATER SAMPLE FIELD DATA SHEETRev, 5/96 <br /> PROJECT NO: <br /> SAMPLE ID <br /> PURGED BY: CLIEN"I'NAME <br /> OMIT SAMPLED BY <br /> LOCATION : <br /> TYPE: Groundwater Surface Water <br /> Leacha(c Otter <br /> CASING DIAMETER(inches): 2 3 ' 4 <br /> 4.5 b Other <br /> CASING ELEVATION(feet/MSL) : VOLUME IN CASINGal. <br /> DEPTH OF WELL(feet) : {g ) <br /> CALCULATED PURGE{gal.) : <br /> DEPTH OF WATER(feet) : ACTUAL PURGE VOL. at. <br /> {g ): <br /> DATEPURGED: <br /> END PURGE: <br /> DATE SAMPLED: SAMPLING TIME. <br /> TIME VOLUME pH E.C. TEMPERATURE TURBIDITY <br /> (2400 HR) al. TIME <br /> (lemh05/cm@25°c) ('F) (visual/N7U) (2400 HR) <br /> OTHER: <br /> ODOR: <br /> � <br /> FIELD QC SAMPLES COLLECTED AT THIS WELL(i.e. FB-I,XDUP-1): (cosALrO-100) (N>v 0_2pp�" <br /> PURGING EQUIPMENT <br /> —` SAMPLING EQUIPMENT <br /> -2"Bladder Pump Bailer(Teflon) .` <br /> 2"Bladder Pump Bailer(Teflon) <br /> Centrifugal Pump Bailer(PVC) <br /> Bomb Sampler Bailer(Stainless Steel) <br /> Submersible Pump Bailer(Stainless Steel <br /> Well Wizard"' ) Dipper Submersible Pump <br /> Dedicated Well Wizard <br /> Other: Dedicated <br /> Other: <br /> WELL INTEGRITY: <br /> REMARKS: LOCK: <br /> pH,E.C.,Temp.Meter Calibration: Date: <br /> Time: Meter Serial No.: <br /> E.C. 1000 �— �— <br /> pH 7 � pH 10 / <br /> Temperature°F pH 4 / <br /> SIGNA'T'URE: <br /> REVIEWED BY: PAGE OF <br /> FIGURE <br /> r <br /> :EM:CNWATER SAMPLE FIELD DATA SHEET <br /> �J A-2 <br />