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SECQR International Inc. <br /> WATER SAMPLE FIELD DATA SHEET <br /> PROJECT# A)00V S - 001 PURGED BY- /L WELL 1 D <br /> t3 ENT NAME t),i-S O SAMPLED BY ILII/ SAMPLE LD wtGJ_V <br /> TION ��n,0 _ QA SAMPLES <br /> DATE PURGED _jZ6 START(2-400hr) $--Ore END(2400hr) 8= <br /> DATE SAMPLED 121 ' / SAMPLE TIME(2400hr) <br /> SAMPLE TYPE Groundwater V Surface Water Treauneet Effluent Other <br /> CASING DIAMETER 2" ✓ 3' 4" 5' 6' 8" Otter <br /> Cog Volume-(gallons per foot) (0.17) (0.38) (0-67) (1 02) (1 50) (2-60) ( } <br /> DEPTH TO BOTTOM(feet) CASING VOLUME(gal) <br /> DEPTH TO WATER(feet) CALCULATED PURGE(gal) <br /> WATER COLUMN HEIGHT(feet) = 'L'L-�/ ACTUAL PURGE(gal) = S 0 <br /> FIELD MEASUREMENTS <br /> DATE TRE VOLUME TEW. CONDUCTIVTI'Y pH COLOR TURBIDITY <br /> (2400hr) (gal) (degrees F) (urnhoslem) (units) (visaal) (NT U) <br /> w <br /> SAMPLE INFORMATION <br /> SAMPLE DEPTH TO WATER. SAMPLE TURBIDITY <br /> 80%RECHARGE: t<ES NO ANALYSES <br /> ODOR SAMPLE VESSEL/PRESERVATIVE <br /> PURGING EQUIPMENT SAMPLING EQUIPMENT <br /> Bladder Pump Bailer(Teflon) Bladder Pump Bailer(Teflon) <br /> Centrifugal Pump Bailer(PVQ Centnhgal Pump ( PVC or ✓disposable) <br /> Submersible Pump Bailer(Stainless Steel) Submemble Pump Bailer(Stainless Steel) <br /> Peristaltic Pump Dedicated Peristaltic Pump Dedicated <br /> Other Other <br /> Pump Depth ". <br /> WELL 111TEGRIT-Y- OX- LACK#: <br /> REMARKS <br /> SIGNATURE- Page of <br />