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WATER SAMPLE FIELD DATA SHEET Rev 5196 <br /> PROJECT NO SAMPLE ID <br /> PURGED BY CLIENT NAME <br /> OWT SAMPLED BY LOCATION <br /> TYPF 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 EC TEMPERATURE TURBIDITY TIME <br /> (2400 HR) (gal) (units) (pmhos/cm(LD25°c) ("F) (visual/NTU) (2400 HR) <br /> OTHER ODOR <br /> (COBALT 0-100) (NTU 0-200) <br /> FIELD QC SAMPLES COLLECTED AT THIS WELL (i e FB-1 XDUP-1) <br /> PURGING EQUIPMENT SAMPLING EQUIPMENT l <br /> 2"Bladder Pump Bader(Teflon) 2"Bladder Pump Bailer(Teflon) <br /> Centrifugal Pump Bailer(PVC) Bomb Sampler Bader(Stainless Steel) <br /> Submersible Pump Bailer(Stainless Steel) Dipper Submersible Pump <br /> Well Wzardl" Dedicated Well WizardTM 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 I pH 7 / pH 10 I pH 4 ! <br /> Temperature"F <br /> SIGNATURE REVIEWED BY PAGE OF <br /> FIGURE <br /> E M C Q N WATER SAMPLE FIELD DATA SHEET A-2 <br />