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WATER SAMPLE FIELD DATA SHEET Rev. 5/96 <br />PROJECT NO: SAMPLE ID: <br />PURGED BY: CLIENT NAME: <br />SAMPLED BY: LOCATION: <br />TYPE: Groundwater Surface Water Leachate Other <br />CASING DIAMETER (inches): 2 3 4 4.5 6 Other <br />CASING ELEVATION (feet/MSL) : <br />VOLUME IN CASING (gal.) : <br />DEPTH OF WELL (feet) : <br />CALCULATED PURGE (gal.) : <br />DEPTH OF WATER (feet) : <br />ACTUAL PURGE VOL. (gal.) : <br />DATE PURGED : END PURGE: <br />DATE SAMPLED : SAMPLING TIME: <br />TIME VOLUME pH E.C. TEMPERATURE TURBIDITY TIME <br />(2400 HR) (gal.) (units) (µmhos/cm@25°c) (°F) (Visual/NTU) (2400 HR) <br />OTHER <br />ODOR: <br />(COBALT 0-100) (NTU 0-200) <br />FIELD QC SAMPLES COLLECTED <br />AT THIS WELL (i.e. FB -1, )DUP-1) : <br />PURGING EQUIPMENT <br />SAMPLING EQUIPMENT <br />2" Bladder Pump <br />Bailer (Teflon) <br />2" Bladder Pump <br />Bailer (Teflon) <br />Centrifugal Pump <br />Bailer (PVC) <br />Bomb Sampler <br />Bailer (Stainless Steel) <br />Submersible Pump <br />Bailer (Stainless Steel) <br />Dipper <br />Submersible Pump <br />Well Wizard"" <br />Dedicated <br />Well WizardTm <br />Dedicated <br />Other: <br />Other: <br />WELL INTEGRITY: <br />REMARKS: <br />LOCK: <br />pH, E.C., Temp. Meter Calibration: Date: Time: Meter Serial No.: <br />E.C. 1000 / pH 7 / pH 10 / pH 4 <br />Temperature °F <br />SIGNATURE: REVIEWED BY: PAGE <br />WATER SAMPLE FIELD DATA SHEET <br />I <br />OF <br />FIGURE <br />