Submit to:
Houston-Galveston Area Council
Clean Rivers Program
P.O. Box 22777
Houston TX 77227-2777
[email protected]
WATER QUALITY MONITORING FORM—FRESH
Group ID Ask us if unsure
Site ID # number
Sample Date date of water testing
Monitors ID # Please enter ID numbers here (name is optional)
Site Description Location description information - not street address
Sample Time
MM-DD-YY
(military: HHMM)
Meter Calibration: (Within 24 hours of sampling)
Calibration
Conductivity
YES
Initial Meter Reading
Meter Adjusted To
date calibrated
time calibrated
number
in C not F
number
number
Reagents:
TDS Low/3
TDS High/4
1st titration 1st result
2nd titration
where measured
Total Depth (meters)
2nd result
choose one
choose one
number of days
to tenth inch
Period
(28-31 hrs.)
number of hours
SAMPLE 1
Sample Size
Number of samples
Colonies
Counted
FLOW SEVERITY
1-no flow 2-low 3-normal 4-flood 5-high 6-dry
ALGAE COVER 1-absent 2-rare (<25%) 3-common
(26-50%) 4-abundant (51-75%) 5-dominant (>75%)
WATER COLOR 1-no color 2-light green 3-dark
green 4-tan 5-red 6-green/brown 7-black
WATER CLARITY
1-clear 2-cloudy 3-turbid
WATER SURFACE
1-clear 2-scum 3-foam 4-debris 5-sheen
WATER CONDITIONS
1-calm 2-ripples 3-waves 4-white caps
WATER ODOR
1-none 2-oil 3-acrid (pungent)
4-sewage 5-rotten egg
6-fishy 7-musky
PRESENT WEATHER
1-clear 2-cloudy 3-overcast 4-rain
DAYS SINCE LAST SIGNIFICANT PRECIPITATION
(runoff)
o
INCUBATION
SAMPLE 2
Field Observations
choose one
choose one
Bacteria (E. coli) Test and Observations
Colonies
Counted
SECCHI Disk or Tube Transparency
(Meters)
choose one
NO
List any reagents that are expired or that you are out
of. You will be contacted about replacement.
Dissolved Oxygen (mg/L)
convert to meters
choose one
choose one
List Expired Regents OR reagents that need to be replaced.
Conductivity
to tenths pH (Standard Units)
choose one
YES
Are any reagents expired?
0
choose one
choose one
Standard Temp (C )
in C not F Water Temperature (C )
choose one
0
Standard Value
in C not F Air Temperature (C )
Ave. of 1 & 2 to tenth
NO
choose one
Time
0
Average
Below
convert to meters
Meters [not total depth]
Date
Core Test and Measurements
Number be sure to
adjust if
using High
Sample Depth
time tested in military time
number
X Dilution Factor
Sample Size
number
Temp. ( C)
o
(33+/-3 C)
Dilution Factor
(mL)
insert from above
X Dilution Factor
insert from above
(100/sample size)
see formula above
Colonies
/100 mL
= number
Dilution Factor
(mL)
Number of samples
in C not F
(100/sample size)
see formula above
= number
Colonies
/100 mL
FIELD BLANK: E.coli colony growth
YES
choose one
NO
choose one
DATA QUALITY REVIEW: Checklist Completed
YES
choose one
NO
choose one
Measurement and Field Observations Comments
Add additional information or test results in this area.
(Inches) RAINFALL ACCUMULATION (last 3 days)
MINUTES (Total Time Spent
Sampling and Traveling)
CERTIFIED MONITOR’S SIGNATURE
DATA MANAGER’S SIGNATURE
in minutes
MILES (Total Roundtrip
Distance Traveled)
in miles
TOTAL NUMBER OF
PARTICIPANTS
number
Please sign here
DATE
date of test
office use only
DATE
office use only