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WELL MONITORING/SAMPLING <br />FIELD DATA SHEET <br />Client/ C +f V A- otQ <br />Facility # q -- 71 � 5 -- <br />Address: <br />_ <br />_ Address: 30W&r <br />City: L6 D_ e- 4 <br />Well ID - I Well Condition <br />Well Diameter � Hydrocarbon <br />Total Depth -IL <br />Depthto Water <br />X VF <br />Purge Disposable Bailer <br />Equipment: Bailer <br />Stack <br />Suction <br />Grundfos <br />Other: <br />Starting Time: <br />Sampling Time: <br />Purging Flow Rate: _ QP- <br />Did <br />PTDid well de -water? <br />Time Volume PH <br />(PL) <br />.yob#: _ 3 jb_ q <br />Date: _%- zy - 6 <br />Sampler: S 1-23- LE Zy 4 L4, <br />Amount Balled <br />thickness u- (product/water)' (GAi <br />VOIUTM 2'= 017 3" - 0.38 1"- 0 66 <br />Factor (VF) 6" - 150 12' — S 80 <br />X 3 (case volume) — Estimated Purge Volume JGAi I <br />Sampling <br />Equipment: Disposable Bader <br />Bailer <br />Pressure Bader <br />Grab Sample <br />Other. <br />Weather Conditions. <br />Water Calor: <br />Sediment Description: <br />If yes, Time: <br />Odor: <br />Volume: <br />• <br />Conductivity Tempesabm DO ORP AUml3t►W <br />r mhoff/cm -C (mg/i.) (mV) (PPM) <br />LABORATORY INFORMATION <br />SAMPLE 10 (f) - CONIAiNER REFRIG. PRESERV. TYPE BORATORY ANALYSES <br />• "16 <br />COMMENTS: 0 <br />sn��.wu.mA <br />