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WELL MONITORINGISAMPLING <br /> FIELD DATA SHEET <br /> Client/ <br /> Facility d� Z 3 Job#• Z"-,J-,6z) q �` <br /> Address: Date: <br /> City: Sampler: <br /> Well ID u Well Condition <br /> - <br /> Well Diameter in Hydrocarbon Amount Sailed <br /> Thickness CP Ifeet� iproductlwater} Gallons <br /> Total Depth Volume 2" = 0 17 3" = 038 4" = 0 66 <br /> Factor(VF) 6" = 150 12"= 5 80 <br /> Depth to Water ft <br /> G X VF =j X 3 (vasa volume) = Estimated Rc:rge VoIL-e �• iaal <br /> I <br /> Purge r Sampling <br /> Equipment: Bailer Equipment: Disposable B 4 ea ! <br /> Stack Bai er <br /> Suction Pressure Bailer <br /> Grundfos Grab Sample <br /> Other Other <br /> Starting Time <br /> Weather Conditions <br /> Sampling Time �� • Ls Water Color Odor <br /> Purging Flow Rate gpm Sediment Description <br /> Did well de-water? N.e7 If yes, Time Volume ai <br /> Time Volume PH Conducunty Temperature D O ORP Alkaluuty <br /> ( µm_hoslcm7c1Q0 0 (mg/L) (mV) (PPM) <br /> LABORATORY INFORMATION <br /> SAMPLE 10 1#1 - CONTAINER REFRIG PRESERV TYPE / LABORATORY ANALYSES <br /> U— ! 19 Y HCI SEQUOIA TPH(G)1btex1mtbe <br /> -� 1 z vD A <br /> Z tr J 4 �Zdd s dK <br /> .� 1 r S e r NO Al f -� 71W <br /> COMMENTS <br /> 9197 14 1dAt inn <br />