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WELL MONITORING/SAMPLING <br /> FIELD DATA SHEET <br /> Client/ <br /> Facility-4;-# Job*: <br /> Address: Date: 9LI 5- <br /> City: <br /> City: Sampler: <br /> Well ID S Well Condition: <br /> Well Diameter in Hydrocarbon Amount Bailed <br /> Thickness _ (feet) (productlwaterl — ICZallonsl <br /> Total Depth ft. Volume 2" = 0 17 3" = 038 4" = 0 66 <br /> Depth to Water 4�� � Factor(VF) 6" = 150 , 12" = 5 80 <br /> X VF – X 3 (case volume) = Estimated Purge Volume (gal E <br /> Purge Disposable Bailer Sampling <br /> Equipment. Bailer Equipment: Disposable Baler <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 _ _ „corn Sediment Description <br /> Did well de-water? If yes, Time Volume l <br /> Time Volume pH Conductivity Temperature D 0 Oltp Alkaluuty <br /> (gal µmhos/c n)d00 .p (mg L) (mV) (ppm) <br /> LABORATORY INFORMATION <br /> SAMPLE Ip M - CONTAINER REFRIG PRESERV TYPE i. LABORATORY ANA[YSF4 <br /> COMMENTS. - F C£ d F MA.I'?J Fv /� <br /> 9197 neldsOrm <br />