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WELL MONITORINGISAMPLING <br /> FIELD DATA SHEET <br /> Client! <br /> Facility # x c ` Job#: �d z ' • <br /> _ Address: - .'� Date: �zfa <br /> City: Sampler: <br /> Well 1D F(Gam'- Well Condition: <br /> Y <br /> Well Diameter <br /> Hydrocarbon Amount Bailed <br /> Thickness: (productlwstar): <br /> Total Depth -ft- yds r Q 0.17 3"-038 1'-066 <br /> Factor(M 6"- 1S0 14"-5 80 <br /> Depth to Water Z`� •�S �- <br /> X VF m = X 3 Icese volume) Q Estimated Purge Volume: S _10a <br /> Purge Disposable Bailer Sampling <br /> Equipment: Bailer EquipmentsDispo ble Bay elel <br /> Sailer <br /> Suction Pressure Bailer <br /> Grundfos Grab Sample <br /> Other: Other: <br /> Starting Time: o:/0 — Weather Conditions: <br /> Sampling Time: I p Water Color. n• Odor- <br /> Purging /-,Lt <br /> ^_ <br /> Purging Flow Rate: � Sediment Description. <br /> Did well de-water? 1 _ If yes; Time: Volume. trial 1 <br /> Tune Volume PH Conductivity Temperature Do. ORP Alkgkdty <br /> (gaL) gmhos,/c , (mom) (mV) (Ppm) <br /> -Z <br /> 0`1 •� � •s3 137- 1 <br /> LABORATORY INFORMATION <br /> SAMPLE ID (f)- CONTAINER REFRIG, PRESERV.TYPE LABORATORY ANALYSES <br /> =d G Ali iL-L^tto c= <br /> ` tda) <br /> COMMENTS: • <br /> 9197.n.w.Lh r, <br />