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WELL MONITORING/SAMPLING <br /> FIELD DATA SHEET <br /> Facility # o Job# <br /> Address i U 7 Anc, Date � f <br /> City T 9ochco CJ`s __ Sampler G h kV" <br /> Well ID � Well Condition �% `�y c�cl_ <br /> Well Diameter / Hydrocarbon Amount Bailed <br /> / Thickness -in_ (productlwater) faaLl <br /> Total Depth J' ` -- Volumc 2" =0 17 3" = 0 38 4" = 0 66 <br /> Factor(VI) 6" = 1 50 12" = 5 80 <br /> Depth to Water n- <br /> X VFyr"` =61—Z" X 3 (case volume) = Estimated Purge Volume - / Lau <br /> Purge Disposable Bailor Sampling <br /> Equipment Basle Equipment isposable Bailer <br /> (Auction Pressure Bailer <br /> Grundfos Grab Sample <br /> Other Other <br /> tarting Time G�y - Weather Conditions rI (u -- <br /> Sampling Time rf�� Water Color ✓ Odor <br /> Purging Flow Rate /' Spm- Sediment Description Gv <br /> Did well de-water? if yes, Time Volume <br /> Time Volume pH Conductivity Temperature D O ORP Alkaluuty <br /> un-hos/em C (mF/I-) (-V) (PP-) <br /> LABORATORY INFORMATION <br /> SAMPLE ID (1/) - CONTAINER REFRIG PRESERV TYPE LABORATORY ANALYSES <br /> M10 3 x 40m/VOA HCL TPH Gas/BTEX,MTBE <br /> K)—j q f GM <br /> OMMENTS I`1 ► L �'ePZ. <br /> 9197 WWI lr+n <br />