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WATER SAMPLE FIELD DATA SHEET Rev 5196 <br /> rik** <br /> PROJECT NO SAMPLE 1D <br /> lie U0 PURGED BY CLIENT NAME <br /> QWT SAMPLED BY LOCATION <br /> TYPE Groundwater Surface Water Leachate Other <br /> CASING DIAMETER (inches) 2 3 4 45 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) (prnhos/cm@25°c) (°F) (visual/NTU) (2400 HR) <br /> iOTHER ODOR <br /> (COBALT 0-100) (NTU 0-200) <br /> FIELD QC SAMPLES COLLECTED AT THIS WELL(i a FB-1,XDUP-1) <br /> PURGING EQUIPMENT SAMPLING EQUIPMENT <br /> 2"Bladder Pump Bailer(Teflon) 2"Bladder Pump Bader(Teflon) <br /> Centrifugal Pump Bailer(PVC) Bomb Sampler Bader(Stainless Steel) <br /> Submersible Pump Bailer(Stainless Steel) Dipper Submersible Pump <br /> Well WizardTl, Dedicated Well WizardT`" 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 ! pH 7 1 pH 10 ! pH 4 ! <br /> Temperature"F <br /> SIGNATURE REVIEWED BY PAGE OF <br /> FIGURE <br /> • -Q*N EMCON WATER SAMPLE FIELD DATA SHEET A-2 <br />