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WATER SAMPLE FIELD DATA SHEET Rev 1/92 <br /> PROJECT NO G11— (4' SAMPLE ID <br /> EMCON PURGED BY T /[LA CLIENT NAME <br /> SSOGi�TEi <br /> SAMPLED BY LOCATION TX*'y, C4 <br /> TYPE Ground Water x Surface Water Leachate Other <br /> CASING DIAMETER(inches) 2x 3 4 4 5 6 Other <br /> CASING ELEVATION(feet/MSL) VOLUME IN CASING (gal.) <br /> DEPTH OF WELL (feet) a�'g CALCULATED PURGE (gal ) <br /> DEPTH TO WATER (feet) �' 4 o ACTUAL PURGE VOL (gal.) <br /> DATE PURGED I Q Z End Purge 1 I O S <br /> DATE SAMPLED Sampling Time <br /> TIME VOLUME pH E C TEMPERATURE COLOR TURBIDITY <br /> (2400 Hr) (units) (i "25'C) (09 (visualloobalt) (viaual/NTU) <br /> /oy5-" i"t -;�-r3 .3 ogo st. B ►� ��N <br /> tar` ' 3 qo 711 <br /> Ila I rd `s Flo lz <br /> r Z.>' 00 ?2"3 <br /> 4- <br /> OTHER- $R W,RLL-odpr# ('1'� ODOii -5ZI GWI- N- Hl� <br /> (COBALT 0-100) (NTU 0-200) <br /> FIELD QC SAMPLES COLLECTED AT THIS WELL (La.FB-1,X-DUP-1) Me <br /> PURGING EQUIPMENT SAMPLING EQUIPMENT <br /> 2'Bladder Pump Bailer(Tenon®) r Bladder Pump d�c— Bann(Te*no) <br /> Centrifugal Pump Bader(PVC) " Bomb 5arnpier Bailer(Se Steel) <br /> Submersible Pump Bailer(Stainless Steel) Dipper Submerskile Pump <br /> WeN-witardm Dedicated well Wizardm Dedicated <br /> Other - other <br /> WELL INTEGRITY, C�0 D " 7 5X-11 GAT LIP 0 LED [v LOCK#a O t/6Y <br /> REMARKS <br /> PH. I C-,Temp Meter Calibration Data 1Y19 2 Time /Q/s MaLar serial No: <br /> EC 1000 101E /099 pH 7 L/ rOQ pH 10 I—LYL=. pH 4 I <br /> Temperature °F 9'-t <br /> Signature —2&r LA-- —- - Reviewed B./"QM Page � of 1 <br />