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WELL MONITORING/SAMPLING <br /> FIELD DATA SHEET <br /> Client/ Manf��Facility4k Job#: <br /> . Address: Date: -2LI s19 <br /> City: _ SAD:r'k n Sampler: <br /> Well ID tel— f Well Condition- <br /> Well Diameter in. Hydrocarbon Amount Bailed <br /> Thickness fee (product/water) (Gallons) <br /> Total Depth Volume 2" = 0 17 3"=0 38 4" =0 66 <br /> Depth to Water {v <br /> f �+ q ftFactor(VF) 6" = LSO 12' =3 80 <br /> X VF = X 3 (case volume) = Estimated Purge Volume (gal f <br /> Purge Disposable Bailer Sampling <br /> Equipment Bailer Equipment: Disposable Bailer <br /> Stack Bailer <br /> Suction Pressure Bailer <br /> Grundfos Grab Sample <br /> Other Other <br /> Starting Time Weather Conditions <br /> Sampling Time Water Color Odor <br /> Purging Flow Rate gom Sediment Description <br /> Did well de-water? If yes, Time Volume .,_ (gal) <br /> Time Volume pH Conductivity Temperature DO ORP Alkahmty <br /> (gal) µmhos/cxnXl00 op (mg/L) (mV) (ppm) <br /> LABORATORY INFORMATION <br /> SAMPLE ID [#) - CONTAINER REFRIG PRESERV TYPE LABORATORY ANALYSES <br /> Het <br /> COMMENTS. MO1 d 1 o4 fv�yq <br /> WS7 n.waUTM <br />