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WELL MONITORING/SAMPLING <br /> FIELDS DATA SHEET <br /> Client/ <br /> Facility # i Job#: /.3 FL <br /> Address: �� Date: <br /> City: Sampler: ac-S <br /> Well ID v - Well Condition: <br /> Well Deameter Hydrocarbon Amount Bailed <br /> Thickness: �6` - Jm- Iaroductlwator): <br /> Total Depth Z�� Voluzoe r-0.17 3•-038 'r= 0.� <br /> Depth to Water LT.O(- ft Facwr CM W- 150 12"=5.90 <br /> X VF 0'6 +_L.Cs..Z,ir X 3(cava volume) - Estimated Purge Volurm: <br /> Purge Disposable Bailer Saran una <br /> EgLdpment: Bailer Equipment: sable Bail <br /> S Bailer <br /> suction Pressure Bailer <br /> Grundfos Grab Sample <br /> Other: Other: <br /> Starting Time: Z;S Weather Conditions: <br /> Sampling ram: t 11.2k P Water Color; Odor;.. <br /> Purging Flow Rate: .,21 tin Sediment Description: <br /> Did well do-water? X0 If yes; Time: Volume: <br /> Time Volume pH CoxrdueMq TempmaLu t D.O. ORP Av <br /> l3 <br /> (to 2Z .Sa tha 6S� - - <br /> 3_ <br /> LABoAAToRY wFoRmAmonl <br /> SAMPLE 10 If)- CONTAINER REFRIG. PHESERV.TYPE LABORATORY ANALYSES <br /> ifW ✓.c'"X VVA Vsal. `� 1-Irrc. UPSA T <br /> M <br /> COMMErm: <br /> 4 <br />