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® i <br /> WATER SAMPLE FIELD DATA SHEET Rev,5196 <br /> PROJECTNO: SAMPLE ID: I <br /> PURGEDBY: CLIENT NAME: <br /> SAMPLED BY: LOCATION: <br /> TYPE: Ground-water Surface Water Leacbate Other <br /> CASING DIAMETER(inches): 2 3 4 4.5 6 Other <br /> CASING ELEVATION(1eet/A4SL): VOLUME IN CASING(gal.): <br /> DEPTH OF WELL(feet): CALCULATED PURGE(gal.): <br /> DEPTH OF WATER(feet): ACTUAL PURGE VOL.(gal.): <br /> is <br /> DATE PURGED: END PURGE: <br /> DATE SAMPLED: SAMPLING TINE: <br /> TDJE VOLUME pH E.C. TEMPERATURE TURBIDITY TIME <br /> (2400 HR) (gal.) (units) (p-ho;/cm iQ+25"c) CF) (visoaV14TU) (2400 HR) j <br /> I <br /> I <br /> i <br /> OTHER: ODOR <br /> (COBALT o-ioa) <br /> FIELD QC SAMPLES COLLECTED AT THIS WELL(i.e.FB-1,XDUP-1): t <br /> I <br /> PURGING EOUIPNIENT SAWLING EQUIPA�IENT ! <br /> 2"BladderPump Bailer(Teflon) 2"Bladder Pump Baiter(Teflon) y <br /> i <br /> Centrifugal Pump Bailer(PVC) Bomb Sampler Bailer(Stainless Steel) <br /> Submersible Pump Bailer(Stainless Steel) Dipper Submersible Pump <br /> AIM Wizard"[ Dedicated Well Mrand'" Dedicated <br /> Other. Other: <br /> WELL INTEGRITY: LOCK: <br /> REMARKS: <br /> S <br /> e <br /> pH,E.C.,Temp.Meter Calibration: Date: Time: Meter Serial No.: <br /> 6 <br /> E.C.I000 1 . pH T / pH 10 ! pH 4 I <br /> Temperature"F <br /> i <br /> SIGNATURE: REVIEViTD BY: PAGE OF <br /> FIGURE <br /> WATER SAMPLE FIELD DATA SHEET <br /> S <br /> i <br />