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WELL MONITORING/SAMPLING <br /> FIELD DATA SHEET <br /> l0client / FaciIity Urifi'alJ_Formpr I.Anei -al #9R5S[ Job#' <br /> Address: Date: ../I j zL�Ss <br /> City: SIQCKTnN, rA Sampler: _. Lai±is Arr4in. <br /> Well ID Well Condition <br /> Well Diameter 2 Hydrocarbon Amount Bailed <br /> Thickness (product/wated <br /> Total Depth $�%Ao ft Volume 20-017 3"= 038 4"=0 66 <br /> Depth to Water <br /> ZS k Factor(VF) 6"m 150 12"=5 80 <br /> j Z X VF (L- = go X 3 (case volume) = Estimated Purge Volume ) (oaf.) <br /> Purge Disposable Bailer Sampling <br /> Equipment Bailer Equipment sosable Ball r <br /> Stack Bailer <br /> uct Pressure Bailer <br /> Grundfos Grab Sample <br /> Other Other <br /> Starting Time Y-0 Weather Conditions <br /> Sampling Time 3QO Water Color Odor <br /> Purging Flow Rate "� :aL Sediment Description <br /> Did well de-water? X2 If yes, Time Volume +ryai y <br /> i <br /> Tune Volume pH Conductrnty Temperature D O ORP AUWuuty <br /> (gal) prnhos/cm "C (mg/L) (mV) (ppm) <br /> z cs <br /> ej <br /> 71,19 <br /> LABORATORY INFORMATION <br /> SAMPLE 10 {d1 CONTAINER REFRIG PRESERV TYPE LABORATORY ANALYSES <br /> MW- (p 3 x 40mfVOA Y HCL SEQUOIA TPH-G/BTEX/ MT 9c <br /> I <br /> COMMENTS <br /> I <br />