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Y UA)� <br /> WELL MONITORING/SAMPLING <br /> FIELD DATA SHEET <br /> lientl t'1 <br /> aciiity# Ck _ (C) Jab#: _ R <br /> tddres,s: ry Rn Date: <br /> Sampler: ' <br /> Well ID Well Condition: <br /> Nell Diameter a Hydrocarbon Amount Bailed <br /> Thickness` rl'; roducVwats -j' <br /> Total Depth • $ volume 2'-017 3" -0.38 40-0.66 <br /> Depth to Water <br /> �C Faccor M 6'- 1.50 12" w 5.80 <br /> X VF X 3(case volume) - Eatlmated Purge Volume: IQsi.I <br /> Purge Disposable Bailer Sampling <br /> Equipment: Bailer Equipment: isposable Beller <br /> Stack <br /> Suction Pressure Bailer <br /> Grundfos Grab Sample <br /> Other. Other: <br /> Starting Time: Weather Conditions: <br /> Sampling Time: er Color: Odor:— <br /> s <br /> Purging Flow Rete: Sediment Description: <br /> Did well de-water? H yes; Time: Volume; <br /> Time volwne Conduc"tp Tem D.O. ORP AnaAaty <br /> (MV) (PPM) <br /> LABORATORY INF0RMATION <br /> SAMPLE 10 (0- CONTAINER AEFRIG. PRESERV.TYPE LABORATORY ANALYSW <br /> V0AVlAl <br /> s1:eEleu► <br /> « t` /Y. f <br /> COMMENTS: <br /> s197-NddOL M <br />