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SP wx inienuulonuc ,lice-. <br /> WATER SAMPLE FIELD DATA SKEET <br /> 1 Z �p PURGED BY t S11uf'` WELL I D T <br /> PROJECT 0 a77. (� 1$ S s`y <br /> NAME Ar'Lcp ZO�iS SAMPLED BY d ►l�r SAMPLE I D <br /> TION 'S ~Trl— ` fL-L QA SAMPLES y� <br /> DATE PURGED N P START(24001ir) END (2400hr) r-` <br /> DATE SAMPLED 12 SAMPLE TIME(2400lir) <br /> SAMPLE TYPE Groundwater <br /> x Surface Water Treatment Effluent Other <br /> 2" 3- 4- S-_ 6- 8" Oilier <br /> CASING DIAMETER (1 02} (1 50) (2 60) ( } <br /> Casing Volume {gallons per foot) {0 17) (0 38) (067) <br /> DEPTH TO BOTTOM (feet) _ CASING VOLUME(gal) <br /> 0 CALCULATED PURGE(gal) _ <br /> DEPTH TO WATER{feet) = <br /> WATER COLUMN HEIGHT(feet} = i <br /> ZO ACTUAL PURGE(gat) _ <br /> FIELD MEASUREMENTS <br /> VOLUME TEMP CONDUCTIVITY pH COLOR TURBIDITY <br /> DA TIME <br /> (24003ir) (gal) (degrees F) (umhoskm) (units) (visual) (NTJ) <br /> SAMPLE INFORMATIONSAMPLE TURBIDITY o <br /> SAMPLE DEPTH TO WATER N O '- <br /> ANALYSES: - <br /> 80% RECHARGE YES NO � ` l <br /> ODOR- <br /> SAMPLE VESSEL I PRESERVATIVE <br /> PURGIN PMENT SAMPLING EQUIPMENT <br /> Bailer(Teflon) Bladder Pump Bailer(Teflon) <br /> Bladder Pump Centrifugal Pump >_Bailer( _PVC or disposable) <br /> Centrifugal Pump Bader(PVC) <br /> Bailer(Stainless Steel) Submersible Pump Bailer(Seamless Steel) <br /> Submerstble Pump Pertstaluc Pump Dedicated <br /> Other_ <br /> Penstaluc Pump Dedicated <br /> Other <br /> Pump Depth <br /> WELL INTEGRITY Q <br /> OCL CLQ, `fL LOCKJt <br /> REMARKS <br /> kj Page of Lo <br /> SIGNATURE 'A <br />