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WATER SAMPLE FIELD DATA SHEET Rev. 5J96 <br />PROJECT NO : SAMPLE ID: <br />PURGED BY: CLIENT NAME : <br />SAMPLED BY: LOCATION: <br />TYPE: Groundwater Sul -face Water Leaehate Other <br />CASING DIAMETER (inches): 2 3 4 4.5 b Other <br />CASTNG ELEVATION (feelJMSL) : VOLUME IN CASING (gal.) : <br />DEPTH OF WELL (feet) : CALCULATED PURGE (gal,) : <br />DEPTH OF WATER (feet) : ACTUAL PURGE VOL. (gal.) <br />DATE PURGED : <br />END PURGE., <br />DATE SAMPLED: <br />SAMPLING TIME : <br />TIME VOLUME <br />pH <br />E.C. TEMPERATURE <br />'TURBIDITY TIME <br />(2400 HR) (gal.} <br />(Units} <br />(pmApslunQ25`o) {°F) <br />(risuaI/14TUj (240DHR I <br />OTHER: <br />ODOR: <br />(COBALTo.loo) (TUo•260) <br />FIELD QC SAMPLES COLLECTED AT THIS WELL <br />(i.e. FB -1, XDUP-1) : <br />PURGING EQUIPMENT <br />SAWLTNG <br />EQUIPENT <br />2"Bladder Pump <br />Bailer(Tenon) <br />2"Bladder Pump <br />Bailer(Tollon) <br />Centrifugal Pump <br />Baller (PVC) <br />Bomb Sampler <br />Bailer (Stainless Steel) <br />Submersible Pump <br />Bailer (Stainless Steel) Dipper <br />Submersible Pump <br />\yell Wizard" <br />Dedicated <br />Well WirardTM' <br />Dedicated <br />Other. <br />Other: <br />WELL INTEGRITY: LOCK: <br />REMARKS: <br />pH, E.C., Temp. Meter Calibration: Date: Time: Meter Serial No.: <br />E.C. 1000. t pH 7 / pH 10 ! pH 4 J <br />Temperature IF <br />SIGNATURE: REVIEWED BY: PAGE OF <br />rA <br />IGURE <br />WATER SAMPLE FIELD DATA SHEET -2 <br />I <br />