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1 WATER SAMPLE FIELD DATA SHEET Rev. ,/s <br /> PROJECT NO : SAMPLE ID: <br /> PURGED BY : ( CLIENT NAME: USA#65 <br /> OWT SAMPLED BY : LOCATION : 2250 West Lodi Ave.,Lodi <br /> ' TYPE: Groundwater Surface Water Leachate Other <br /> CASING DIAMETER(inches): 2 3 &,-- 4 4.5 6 Other <br /> ' CASING ELEVATION(feet/MSL) : VOLUME IN CASING(gal.): 2. o <br /> DEPTH OF WELL(feet): ,Z. CALCULATED PURGE(gal.): Q <br /> ' DEPTH TO WATER(feet): Z ACTUAL PURGE VOL.(gal.): _ <br /> ' DATE PURGED: Lie,1END PURGE : <br /> DATE SAMPLED :'._ _ SAMPLING TIME : <br /> TIME VOLUME ' pH E.C. TEMPERATURE COLOR TURBIDITY <br /> 1400 HR) ( al.) units) (pmhWc 25°c) F) (vjsual) (visual) <br /> iIf. <br /> 1 <br /> OTHER: ODOR: � <br /> (COBALT 0-100) (N-rU 0-200) <br /> FIELD QC SAMPLES COLLECTED AT THIS WELL(i.e.FB-1,XDUP-1) ; <br /> PURGING EQUIPMENT SAMPLING EQUIPMENT <br /> 2"Bladder Pump Bailer(Teflon) 2"Bladder Pump Bailer(Teflon) <br /> Centrifugal Pump Bailer(PVC) Bomb Sampler Bailer(Stainless Steel) <br /> _ Submersible Pump Bailer(Stainless Steel) Dipper Submersible Pump <br /> Well Wizard6 Dedicated Well Wizard6 Dedicated <br /> ' Other: Other: <br /> WELL INTEGRITY: �GJOU _._ LOCK: <br /> REMARKS: <br /> pH,E.C.,Temp.Meter Calibration: Date: 4-eLlJ Time: Meter Serial No.. <br /> E.C. 1000 1 pH 7 / pH 10 / pH 4 1 <br /> Temperature OF <br /> SIGNATURE: _ _ REVIEWED BY.-5X PAGE q OF� _ <br />