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1 <br /> WELL MONITORING/SAMPLING <br /> . FIELD DATA SHEET <br /> CI)ent/ <br /> Facility # Job#: <br /> Address: Y3? /-"&r Date- <br /> City. __ � �� Sampler: tlra4 � <br /> Well ID u�— Well Condition- e z(_ <br /> WellDiameter m_ Hydrocarbon Amount Bailed <br /> qy 91 Thickness (product/water) <br /> Total Depth volume 2" =0 17 3"=038 4" 0 66 <br /> Factor(VF) 6' = 1.50 12"= 5 80 <br /> Depth to Water 9 <br /> 4— X VF = X 3 (case volume) = Estimated Purge Volume t�f <br /> Purge Disposable Bailer Sampling <br /> Equipment Bailer Equipment: Disposable Bailer <br /> Stack Bader <br /> Suction Pressure Bailer <br /> Grundfos Grab Sample <br /> Other Other <br /> Starting Time Weather Conditions <br /> Sampling Time Water Calor Odor <br /> Purging Flow Rate —ten.,, Sediment Description <br /> Did well de-water? If yes, Time Volume (gam <br /> Time Volume pH Conductivity Temperature D O ORP Alkaluuty <br /> (gal ;=hos/cin "C (mg/L) (mV) (Ppm) <br /> LABORATORY INFORMATION <br /> SAMPLE ID (p)- CONTAINER REFRIG PRESERV TYPE LABORATORY ANALYSES <br /> COMMENTS 70 -be. /3'en.74re <br /> e <br />