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WELL MONITORING/SAMPLING <br /> FIELD DATA SHEET <br /> Client/ Hrzn-�Q&pn4".a 'rdr. <br /> Facility--hl-. Job#: <br /> Address: Date: s <br /> City: _ S7�t�'i7�� Sampler: <br /> Well ID Well Condition <br /> Well Diameter in. Hydrocarbon Amount Bailed <br /> Thickness (feet) (product/water)' Gallons <br /> Total Depth volume 2"= 0 17 3" = 038 4' = 0 66 <br /> Depth to Water Factor(VF) 6"= 150 I2"= 5 80 <br /> X VF = X 3 (case volume) = Estimated Purge Volume _ (gal ! <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 i <br /> Time Volume PH Conductivity Temperature D O ORP Alkahnrty <br /> (gal µrnhosIcm)(140 •F (mgrL) (mv) (Ppm) <br /> LABORATORY INFORMATION <br /> SAMPLE ID W - CONTAINER REFRIG PRESERV TYPE i GAORGTnRV .^-.kIAI YSE. <br /> COMMENTS: F�Q44 <br /> 9/97(JeWat f— <br /> I <br />