Groundwater Monitoring Sample Worksheet

Appendix I
Well (8 or less
characters)

Parameter

Date
(mm/dd/yyyy)

Units

Reported
Value
#

PQL

Flags
ND, U, NT, J, D

MDL
-

Ammonia

 -

mg/l

 - - - -
-

Antimony

 -

ug/l

 - - - -
-

Arsenic

 -

ug/l

 - - - -
-

Barium

 -

ug/l

 - - - -
-

Beryllium

 -

ug/l

 - - - -
-

Boron

 -

ug/l

 - - - -
-

Cadmium

 -

ug/l

 - - - -
-

Calcium

 -

mg/l

 - - - -
-

Chromium

 -

ug/l

 - - - -
-

Cobalt

 -

ug/l

 - - - -
-

Copper

 -

ug/l

 - - - -
-

Fluoride

 -

mg/l

 - - - -
-

Hardness

-

mg/l

 - - - -
-

Lead

 -

ug/l

 - - - -
-

Magnesium

 -

mg/l

 - - - -
-

Manganese

 -

ug/l

 - - - -
-

Mercury

 -

ug/l

 - - - -
-

Nickel

 -

mg/l

 - - - -
-

Nitrate/Nitrite

 -

mg/l

 - - - -
-

Phosphorus

 -

mg/l

 - - - -
-

Selenium

 -

ug/l

 - - - -
-

Silver

 -

ug/l

 - - - -
-

Sodium

 -

mg/l

 - - - -
-

Sulfate

 -

mg/l

 - - - -
-

Thallium

 -

ug/l

 - -  - -
-

Total Organic Carbon

 -

mg/l

 - -  - -
-

Vanadium

 -

ug/l

 - - - -
-

Zinc

 -

ug/l

 - - - -
-

Acetone

 -

ug/l

 - - - -
-

Acrylonitrile

 -

ug/l

 - - - -
-

Benzene

 -

ug/l

 - - - -
-

Bromochloromethane

 -

ug/l

 - - - -
-

Bromodichloromethane

 -

ug/l

 - - - -
-

Bromoform

 -

ug/l

 - - - -
-

Carbon disulfide

 -

ug/l

 - - - -
-

Carbon tetrachloride

 -

ug/l

 - - - -
-

Chlorobenzene

 -

ug/l

 - - - -
-

Chloroethane

 -

ug/l

 - - - -
-

Chloroform

 -

ug/l

 - - - -
-

Dibromochloromethane

 -

ug/l

 - - - -
-

1,2-Dibromo-3-chloropropane

 -

ug/l

 - - - -
-

1,2-Dibromoethane

 -

ug/l

 - - - -
-

1,2-Dichlorobenzene

 -

ug/l

 - - - -
-

1,4-Dichlorobenzene

 -

ug/l

 - - - -
-

trans-1,4-Dichloro-2-butene

 -

ug/l

 - - - -
-

1,1-Dichloroethane

 -

ug/l

 - - - -
-

1,2-Dichloroethane

 -

ug/l

 - - - -
-

1,1-Dichloroethene

 -

ug/l

 - - - -
- 

cis-1,2-Dichloroethene

 -

ug/l

 - - - -
-

trans-1,2-Dichloroethene

 -

ug/l

 - - - -
-

1,2-Dichloropropane

 -

ug/l

 - - - -
-

cis-1,3-Dichloropropene

 -

ug/l

 - - - -

-

trans-1,3-Dichloropropene

 -

ug/l

 - - - -
-

Ethylbenzene

 -

ug/l

 - - - -
-

2-Hexanone

 -

ug/l

 - - - -
-

Bromomethane

 -

ug/l

 - - - -
-

Chloromethane

 -

ug/l

 - - - -
-

Dibromomethane

 -

ug/l

 - - - -
-

Methylene chloride

 -

ug/l

 - - - -
-

Methyl ethyl ketone

 -

ug/l

 - - - -
-

Iodomethane

 -

ug/l

 - - - -
-

4-Methyl-2-pentanone

 -

ug/l

 - - - -
-

Styrene

 -

ug/l

 - - - -
-

1,1,1,2-Tetrachloroethane

 -

ug/l

 - - - -
-

1,1,2,2-Tetrachloroethane

 -

ug/l

 - - - -
-

Tetrachloroethene

 -

ug/l

 - - - -
-

Toluene

 -

ug/l

 - - - -
-

1,1,1-Trichloroethane

 -

ug/l

 - - - -
-

1,1,2-Trichloroethane

 -

ug/l

 - - - -
-

Trichloroethene

 -

ug/l

 - - - -
-

Trichlorofluoromethane

 -

ug/l

 - - - -
-

1,2,3-Trichloropropane

 -

ug/l

 - - - -
-

Vinyl acetate

 -

ug/l

 - - - -
-

Vinyl chloride

 -

ug/l

 - - - -
-

Xylenes

 -

ug/l

 - - - -
-

Chemical Oxygen Demand

 -

mg/l

 - - - -
-

Chloride

 -

mg/l

 - - - -
-

Iron

 -

mg/l

 - - - -
-

pH

 -

S.U.

 - - - -
-

Specific Conductance

 -

umhos/cm

 - - - -
-

Total Dissolved Solids

 -

mg/l

 - - - -
- - - - - - - -

Must be in a Separate File

Potassium

 -

mg/l

 - - - -
-

Alkalinity, Total

 -

mg/l

 - - - -
-

Water Level

 -

feet

 - - - -
-

Temperature

 -

deg C

 - - - -
-

Turbidity

 -

NTU

 - - - -
- - - - - - - -

Field Blanks, Trip Blanks, Equipment Blanks and Matrix Spikes Must be in a Different File

 - - - - - - -