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f ltzL U UA to z)r,r_=I <br /> WATER SAMPLE FIELD DATA SHEET <br /> n] <br /> PROTECT No LT LOCAnON: 5bk YIE ,ra alzDi WELL ID #1: Z <br /> CLIENT/STATION No. : - FIELD TECHNICIAN <br /> WELL INFORMATION CASING GAL <br /> Depth to Liquid --- TOB TOC DIAMETER LINEAR FT SAMPLE TYPE <br /> Depth to water G A 1-{1 TOB Ld.g>O TOC ❑ 2 017 'Groundwater <br /> Total depth TOB t S SD TOC ❑ 3 038 ❑ Duplicate <br /> Date Time (2400) 1Z,�-1 ❑ 4 066 Extraction well <br /> ❑ 45 083 ❑ Trip blank <br /> Probe Type ❑ Oil/Water interface ❑ 5 1 02 ❑ Field blank <br /> and © Electronic indicator '0 Z ❑ 6 1 5 ❑ Equipment blank <br /> 10 ; ❑Other, <br /> ❑ 8 26 ❑ Other, <br /> i <br /> Gal/Liner 1 Number of Calculated <br /> TD 3 '�O- DTW_LO,b00 - Z d x Foot __ !t x Casings =Purge--- t/ <br /> DATE PURGED _Z A ,`j(, ^START r 3/ END (2400 hr) y3( PURGED BY: <br /> DATE SAMPLED ?,WP9(, START _ 1 Z.�33 END (2400 hr) __ /?,_`_f 1 _SAMPLEDBY- <br /> TIME VOLUME PH E.C. TEMPERATURE <br /> 7400 Fir �g_1_Z units Lwnhos1crn_0 2_5°C) ° F COLOR TURBIDITY ODOR <br /> 67 I <br /> Cn6Jt 0.100 NTU O 200 Str°n; <br /> Pumped dry Yes / No C6.r Me&ry <br /> cry modemm v.�t <br /> Yetlor U=ht Pone <br /> FIELD MEASUREMENTS AT TIME OF SAMPLE, AFTER RECHARGE: 11� sma <br /> DTw• t&l Z TO Be ,Z3 72U3. �bc�,�t � <br /> PURGING EQUIPMENT/I D. # SAMPLING EQUIPMENT/LD # <br /> ❑ Bailer ❑ Airlift Pump E�Bailer Z3 <br /> [] Centrifugal Pump ❑ Dedicated ❑ Dedicated <br /> ® Other Gme?5Wf, Other <br /> SAMP CNTRL# DATE TIME(2400) No of Cont SIZE CONTAINER PRESERVE ANALYTICCAfLIPARAMETER <br /> REMARKS <br /> 7 <br /> � vAcr+c <br /> SIGNATURE 1`GL%rl y t. G.T tty ;( a~INC <br />