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WELL MONITORINGISAMPLING <br />FIELD DATA SHEET <br />Client/ C l+E V R 0 rn! <br />acility # 9 - S -+Ts Job#. 3 6 4og.0i <br />uiJ� + e+� a Date: Zan <br />Address - <br />City: -5o%rl S _ k ! <br />Cit Io 0 S C Sampler: a <br />Well ID Lk) Well Condition <br />Well Diameter a., rn, Hydrocarbon Amount Bailed <br />_ Thickness feet (product/water) .-[Gallons) <br />Tata! Depth I Volume 2" = 0 17 3'= 0 38 4" = 0 66 <br />Factor (VF) 6"= 1 50 12" = 5 80 <br />Depth to Water ` <br />Aft <br />X VF — X 3 (case volume) = Estimated Purge Volume loaf L <br />Purge Disposable Bailer Sampling <br />Equipme Bailer Equi ment Disposable Bailer <br />Stack Bailer <br />�— Suction Pressure Bailer <br />Grundfos Grab Sample <br />Other Other <br />Starting Time <br />Sampling Time <br />Purging Flow Rate m <br />Did well de -water? <br />• COMMENTS <br />Time Volume <br />(gal ) <br />Weather Conditions <br />Water Color <br />Sediment Description <br />If yes, Time <br />pH Conductivity Temperature <br />;1 oslcrn 6F <br />SUP O <br />Odor <br />Volume LQ411 <br />00 ORP Alkalinity <br />(mg/I.) (� (Ppm) <br />LABORATORY INFORMATION <br />r .n ,rpt rrlat1rA1M9Q /ArrRir; PRESERV TYPE LABORATORY ANALYSFS <br />rM <br />—ROM <br />T� <br />r,�■��� <br />r- <br />;Li <br />ass-rr. <br />9197 fINEaS ftT <br />