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WATER SAMPLE FIELD DATA SHEET Rev. 119 <br /> PROJECT NO: 792065 SAMPLE ID: AW.——z <br /> PURGED BY: - f� CLIENT NAME: - USA 965 <br /> SAMPLED BY : LOCATION : 2250 West Lodi Avenue,Lodi <br /> TYPE: Groundwater Surface Water Leachate Other <br /> CASING DIAMETER finches): 2 '� 3 4 4.5 6 Other <br /> ' CASING ELEVATION(feet/MSL) : --- VOLUME IN CASING(gal,): 3,2- <br /> DEPTH OF WELL(feet) : 12, CALCULATED PURGE(gal.): q _C( <br /> ' DEPTH TO WATER(feet) : Jrf. / ACTUAL PURGE VOL.(gal.): 1 n ( <br /> DATE PURGED: l &V END PURGE ; r-70-7 <br /> DATE SAMPLED: SAMPLING TIME : <br /> l <br /> TIME VOLUME pH E.C. TEMPERATURE COLOR TURBIDITY <br /> ' <br /> 12400 HR) (gal,) {uniul (Nmhoslem®25°e) (°F) (visual) (visual) <br /> L70 $ ter ( 71-(',, L. . <br /> q-2 <br /> OTHER: ODOR: / <br /> (COBALT 0-100) 0.200) <br /> FIELD QC SAMPLES COLLECTED AT THIS WELL(i.e.FB-1,XDUP-1) <br /> PURGING E,QLjIPMENT SAMPLING EQUIPMENT <br /> ' 2"Bladder Pump Bailer(Teflon) 2"Bladder Pump Bailer(Teflon) <br /> Centrifugal Pump Bailer(PVC) Bomb Sampler Bailer(Stainless Steel) <br /> ' _Submersible Pump Bailer(Stainless Steel) Dipper Submersible Pump <br /> Well WizardO Dedicated Weil WizardO 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 ! pH 7 / pH l0 / pH 4 ! <br /> Temperature IF <br /> SIGNATURE: j/ REVIEWED BY: PAGE OF� <br /> i <br />