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WATER SAMPLE FIELD DATA SHEET Rev 179 <br /> PROTECT NO : 20A41-008.001 SAMPLE ID: <br /> • PURGED BY : CLQ CLIENT NAME: USA 465 <br /> OWT SAMPLED BY :_ I LOCATION: 2250 West Lodi Ave.,Lodi <br /> TYPE: Groundwater----j,,- Surface Water Leachate Other <br /> CASING DIAMETER(inches): 2 3 4 4.5 6 Other <br /> CASING ELEVATION(feet/MSL): — VOLUME IN CASING(gal,) : , <br /> DEPTH OF WELL(feet):_ - � CALCULATED PURGE(gal.) : q, . <br /> DEPTH TO WATER(feet): ��.�7 _ ACTUAL PURGE VOL. (gal.) : u �� <br /> DATE PURGED: END PURGE. Ll 7-G <br /> DATE SAMPLED: SAMPLING TIME: 2 <br /> TIME VOLUME ' pH E.C. TEMPERATURE COLOR TURBIDITY <br /> (2400 HR) (gal.) (units) (µmhoslcma-25°0 ff) (visual) (visual) <br /> A. hAj <br /> OTHER: ODOR: <br /> (COBALT 0-100) TU D-200} <br /> FIELD QC SAMPLES COLLECTED AT THIS WELL(i.e. FB-I,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 /> —�ZSubmersible Pump Bailer(Stainless Steel) Dipper Submersible Pump <br /> Well WizardU Dedicated Well WizardQ Dedicated <br /> Other: Other: <br /> WELL INTEGRITY: LOCK: -vl,Lp `i <br /> REMARKS: <br /> PH,E.C.,Temp.Meter Calibration: Date:/ Time: Meter Serial No.: <br /> E.C. 1000 1 pH 7 / pH 10 / <br /> pH 4 <br /> Temperature°F <br /> SIGNA'T'URE: REVIEWED By-- <br /> YPAGE `OF� <br />