SURFACE WATER SAMPLING FIELD DATA SHEET BA/FDS/001/1-00

A. General Information
State Local Government Town Area / street / ward / vil.

River / Stream Name

Basin Name Approximate size of
study area
Brief Description of Site
(describe access to site,
immediate site area /
vegetation type/ etc)
Distance of well to river Distance of houses / Activities around well Tick
bank habitation to well section
 Mineral extraction
<500m <1000m >2000m <10m☐ <25m >25m  Farming (insert type… maize, ☐
☐ ☐ ☐ ☐ ☐ yam, cassava etc)
Sample Collector Date of Sample Collection
DD / MM / YEAR  Livestock farming (Poultry, ☐
piggery, cattle, sheep) etc.
Exact Sampling Time  cooking ☐
(24hr time) HH:MM  Others (specify) ☐
Name & Signature
 Welding / iron melting activity ☐
B. Sampling Information
Sample ID Container No.
GPS Coordinates UTM) Easting: Northing: Elevation:
Field Measurements
Temperature PH. Value Dissolved Oxygen

Conductivity Turbidity Others (specify)

Weather in Past 24hrs Heavy rain ☐ Steady rain☐ Showers☐ Clear / Sunny☐ others☐

Weather Now Heavy rain ☐ Steady rain☐ Showers☐ Clear / Sunny☐ others☐

Flow estimate on field Slow Moderate Fast Not sure

Time Delivered to Lab Date: Time: Received by:
C. Site Pictures (photograph / satellite imagery)

D. Comments (unusual results or conditions, anything worth noting)

Laboratory details: Name of Analyst

Office Use Only

Reviewer Name: Signature: Date:
GROUND WATER SAMPLING FIELD DATA SHEET BA/FDS/002/1-00
A. General Information
State Local Government Town Area / street / ward / vil.

River / Stream Name

Basin Name Approximate size of
study area
Brief Description of Site
(describe access to site,
immediate site area /
vegetation type/ etc)
Distance of houses to river Distance of shrubs / Activities around river bank Tick
bank grasses to river bank section
 Abattoir
<250m <1000m >1000m <100m <250m >250m  Farming (insert type… maize, ☐
☐ ☐ ☐ ☐ ☐ ☐ yam, cassava etc)
Sample Collector Date of Sample Collection
DD / MM / YEAR  Livestock farming (Poultry, ☐
piggery, cattle, sheep) etc.
Exact Sampling Time  Sand mining ☐
(24hr time) HH:MM  Others (specify) ☐
Name & Signature
☐
B. Sampling Information
Sample ID Container No.
GPS Coordinates UTM) Easting: Northing: Elevation:
Field Measurements
Temperature PH. Value Dissolved Oxygen

Conductivity Turbidity Others (specify)

Weather in Past 24hrs Heavy rain ☐ Steady rain☐ Showers☐ Clear / Sunny☐ others☐

Weather Now Heavy rain ☐ Steady rain☐ Showers☐ Clear / Sunny☐ others☐

Flow estimate on field Slow Moderate Fast Not sure

Time Delivered to Lab Date: Time: Received by:
C. Site Pictures (photograph / satellite imagery)

D. Comments (unusual results or conditions, anything worth noting)

Laboratory details: Name of Analyst

Office Use Only

Reviewer Name: Signature: Date:
SEDIMENT SAMPLING FIELD DATA SHEET BA/FDS/003/1-00
A. General Information
State Local Government Town Area / street / ward / vil.

River / Stream Name

Basin Name Approximate size of
study area
Brief Description of
collection method and site
condition

Sample Method Used / How was it collected Type of Sample (check all that apply) Tick
section
 Stream / river
Scooping + Bowl / Wading & from Bank  Wetland / flood plain ☐
Sample Collector Date of Sample Collection
DD / MM / YEAR  Pond ☐
Exact Sampling Time  Grab ☐
(24hr time) HH:MM  Duplicate Copy ☐
Name & Signature  Composite (mixture of 2 samples) ☐
B. Sampling Information
Sample ID Container No.
GPS Coordinates UTM) Easting: Northing: Elevation:
Field Measurements
Temperature PH. Value
Conductivity Others (specify)
Weather in Past 24hrs Heavy rain ☐ Steady rain☐ Showers☐ Clear / Sunny☐ others☐

Weather Now Heavy rain ☐ Steady rain☐ Showers☐ Clear / Sunny☐ others☐

Flow Slow Moderate Fast Not sure

Time Delivered to Lab Date: Time: Received by:
C. Site Pictures (photograph / satellite imagery)

D. Comments (unusual results or conditions, anything worth noting)

Laboratory details: Name of Analyst

Office Use Only

Reviewer Name: Signature: Date:
SOIL SAMPLING FIELD DATA SHEET BA/FDS/004/1-00
A. General Information
State Local Government Town Area / street / ward / vil.

River / Stream Name

Basin Name Approximate size of
study area
Brief Description of
collection method and site
condition

Sample Method Used / How was it collected Type of Sample (check all that apply) Tick
section
 Soil – Dry (Disturbed / Undisturbed)
Soil Auger + Digging  Soil – Wet (Disturbed / Undisturbed) ☐
Sample Collector Date of Sample Collection
DD / MM / YEAR  Wet Composite (mixture of 2 samples) ☐
Exact Sampling Time  Dry Composite (mixture of 2 samples) ☐
(24hr time) HH:MM  Duplicate Copy ☐
Name & Signature  Others ☐
B. Sampling Information
Sample ID Container No.
GPS Coordinates UTM) Easting: Northing: Elevation:
Field Measurements
Temperature PH. Value
Conductivity Others (specify)
Weather in Past 24hrs Heavy rain ☐ Steady rain☐ Showers☐ Clear / Sunny☐ others☐

Weather Now Heavy rain ☐ Steady rain☐ Showers☐ Clear / Sunny☐ others☐

Flow Slow Moderate Fast Not sure

Time Delivered to Lab Date: Time: Received by:
C. Site Pictures (photograph / satellite imagery)

D. Comments (unusual results or conditions, anything worth noting)

Laboratory details: Name of Analyst

Office Use Only

Reviewer Name: Signature: Date: