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form.php
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<?php
session_start();
if (!isset($_SESSION["user"])) {
header("location:index.php");
}
?>
<!DOCTYPE html>
<html lang="en">
<head>
<!-- Latest compiled and minified CSS -->
<meta charset="utf-8">
<link rel="stylesheet" type="text/css" href="assets/css/form_style.css">
<link rel="stylesheet" type="text/css" href="assets/css/bootstrap.css">
<script src="https://ajax.googleapis.com/ajax/libs/jquery/3.2.1/jquery.min.js"></script>
<script src="https://maxcdn.bootstrapcdn.com/bootstrap/3.3.7/js/bootstrap.min.js"
integrity="sha384-Tc5IQib027qvyjSMfHjOMaLkfuWVxZxUPnCJA7l2mCWNIpG9mGCD8wGNIcPD7Txa"
crossorigin="anonymous"></script>
<script src="assets/js/scripts/formScripts.js"></script>
</head>
<body>
<div id="container-all" class="row">
<form id="formData">
<input type="hidden" id="idPoint" value="<?php echo $_GET["idPoint"]?>">
<!--CABECERA DE DATOS-->
<a class="btn btn-default btn-lg" style="float: left;" href="formsList.php?id=<?php echo $_GET["idPoint"]?>">Come Back</a>
<h1 class="text-center">GROUNDWATER SAMPLING LOG</h1>
<table border="1" class="table-responsive table-style">
<tr>
<td colspan="2">
<label for="siteName">SITE NAME:</label>
<input id="siteName" name="siteName" type="text" required>
</td>
<td colspan="1">
<label for="siteLocation">SITE LOCATION:</label>
<input id="siteLocation" name="siteLocation" type="text" required>
</td>
</tr>
<tr>
<td>
<label for="wellNro">WELL NO:</label>
<input id="WellNro" name="wellNro" type="text" required>
</td>
<td>
<label for="sampleId">SAMPLE ID:</label>
<input id="sampleId" name="sampleId" type="text" required>
</td>
<td>
<label for="date">DATE:</label>
<input id="date" name="date" type="date" required style="width: 150px;">
</td>
</tr>
</table>
<!--CUERPO DE LA FORMA-->
<br>
<table border="1" id="purginTable" class="table-responsive table-style">
<tr>
<th colspan="12"><h3 class="text-center">PURGING DATA</h3></th>
</tr>
<tr>
<td colspan="2">
<label for="wellDiameter">WELL DIAMETER (inches):</label>
<input id="wellDiameter" name="wellDiameter" type="number" min="0" step="0.0001">
</td>
<td colspan="2">
<label for="tubingDiameter">TUBING DIAMETER (inches):</label>
<input id="tubingDiameter" name="tubingDiameter" type="number" min="0" step="0.0001">
</td>
<td colspan="4">
<h6 style="font-weight: bold">WELL SCREEN INTERVAL DEPTH:</h6>
<input id="wsi_inf" name="wsi_inf" type="number" min="0" step="0.0001" required style="width:100px;">
<label for="wsi_inf">feet to</label>
<input id="wsi_sup" name="wsi_sup" type="number" min="0" step="0.0001" required style="width:100px;">
<label for="wsi_sup">feet</label>
</td>
<td colspan="2">
<label for="staticDepth">STATIC DEPTH TO WATER (feet):</label>
<input type="number" name="staticDepth" id="staticDepth" min="0" step="0.0001">
</td>
<td colspan="2">
<label for="typePump">PURGE PUMP TYPE OR BAILER:</label>
<input type="text" name="typePump" id="typePump">
</td>
</tr>
<tr>
<td colspan="12">
<p><span style="font-weight: bold;">WELL VOLUME PURGE: 1 WELL VOLUME</span> = (TOTAL WELL DEPTH – STATIC DEPTH TO WATER) X WELL CAPACITY
(only fill out if applicable)
</p>
<div class="row">
<div class="col-lg-3 col-md-6 col-xs-6">
<p id="valueP1">0</p>
</div>
<div class="col-lg-3 col-md-6 col-xs-6">
<p id="valueP2">0</p>
</div>
<div class="col-lg-3 col-md-6 col-xs-6">
<input placeholder="WELL CAPACITY (gallons/foot)" style="float: left" type="number" id="wellCapacity" name="wellCapacity" min="0" step="0.0001">
</div>
<div class="col-lg-3 col-md-6 col-xs-6">
<input id="totalVolume" type="number" step="0.0001" readonly placeholder="RESULT">
</div>
</div>
</td>
</tr>
<tr>
<td colspan="12">
<p><span style="font-weight: bold;">EQUIPMENT VOLUME PURGE: 1 EQUIPMENT VOL.</span> = PUMP VOLUME + (TUBING CAPACITY X TUBING LENGTH) + FLOW CELL VOLUME
(only fill out if applicable)
</p>
<div class="row">
<div class="col-lg-2 col-md-2 col-xs-2">
<input placeholder="PUMP VOLUME(gallons)" style="float: left" id="pumpVolume" name="pumpVolume" type="number" step="0.0001">
</div>
<div class="col-lg-2 col-md-2 col-xs-2">
<input placeholder="TUBING CAPACITY (gallons/foot)" style="float: left" id="tubingCapacity" name="tubingCapacity" type="number" step="0.0001">
</div>
<div class="col-lg-2 col-md-2 col-xs-2">
<input placeholder="TUBING LENGTH (feet)" style="float: left" id="tubingLength" name="tubingLength" type="number" step="0.0001">
</div>
<div class="col-lg-2 col-md-2 col-xs-2">
<input placeholder="FLOW CELL VOLUME (gallons)" style="float: left" id="flowCellVolume" name="flowCellVolume" type="number" step="0.0001">
</div>
<div class="col-lg-2 col-md-2 col-xs-2">
<input type="number" readonly step="0.0001" placeholder="RESULT">
</div>
</div>
</td>
</tr>
<tr>
<td colspan="3">
<label>INITIAL PUMP OR TUBING DEPTH IN WELL (feet):</label>
<input type="number" id="initPumpDepth" name="initPumpDepth" min="0" step="0.0001" required>
</td>
<td colspan="3">
<label>FINAL PUMP OR TUBING DEPTH IN WELL (feet):</label>
<input type="number" id="finalPumpDepth" name="finalPumpDepth" min="0" step="0.0001" required>
</td>
<td colspan="2">
<label>PURGING
INITIATED AT:
</label>
<input type="time" id="initTimePurge" name="initTimePurge" required>
</td>
<td colspan="2">
<label>PURGING ENDED AT:
</label>
<input type="time" id="finalTimePurge" name="finalTimePurge" required>
</td>
<td colspan="2">
<label>TOTAL VOLUME PURGED (gallons):
</label>
<input type="number" id="totalVolumePurged" name="totalVolumePurged" min="0" step="0.0001" required>
</td>
</tr>
<tr>
<th>TIME</th>
<th>VOLUME PURGED (gallons)</th>
<th>CUMUL.
VOLUME
PURGED
(gallons)
</th>
<th>PURGE
RATE
(gpm)
</th>
<th>DEPTH
TO
WATER
(feet)
</th>
<th>pH
(standard units)
</th>
<th>TEMP.
(OC)
</th>
<th>COND.
(circle units)
μmhos/cm
or μS/cm
</th>
<th>DISSOLVED
OXYGEN
(circle units)
mg/L or
% saturation
</th>
<th>TURBIDITY
(NTUs)
</th>
<th>COLOR
(describe)
</th>
<th>ODOR
(describe)
</th>
</tr>
</table>
<div style="text-align: right;">
<a id="addRow" class="btn btn-default btn-xs">Add row</a>
<input id="numberRows" type="number" style="width: 50px;" min="1" value="1">-
<a id="removeRowP" class="btn btn-default btn-xs">Remove row</a>
</div>
<p><span style="font-weight: bold">WELL CAPACITY (Gallons Per Foot):</span> 0.75” = 0.02; 1” = 0.04; 1.25” = 0.06; 2” = 0.16; 3” = 0.37; 4” = 0.65; 5” = 1.02; 6” = 1.47; 12” = 5.88
</p>
<p>
<span style="font-weight: bold">TUBING INSIDE DIA. CAPACITY (Gal./Ft.):</span> 1/8" = 0.0006; 3/16" = 0.0014; 1/4" = 0.0026; 5/16" = 0.004; 3/8" = 0.006; 1/2" = 0.010; 5/8" = 0.016
</p>
<p>
<span style="font-weight: bold">PURGING EQUIPMENT CODES:</span> <span style="font-weight: bold">B</span> = Bailer; <span style="font-weight: bold">BP</span>= Bladder Pump; <span style="font-weight: bold">ESP</span>= Electric Submersible Pump; <span style="font-weight: bold">PP</span> = Peristaltic Pump;<span style="font-weight: bold">O</span>= Other (Specify)
</p>
<table border="1" id="samplingTable" class="table-responsive table-style">
<tr>
<th colspan="10"><h3 class="text-center">SAMPLING DATA</h3></th>
</tr>
<tr>
<td colspan="3">
<label>SAMPLED BY (PRINT) / AFFILIATION:</label>
<input type="text" id="sampledBy" name="sampledBy" required>
</td>
<td colspan="3">
<label>SAMPLER(S) SIGNATURE(S):</label>
<input type="text" id="sampleSig" name="sampleName" required>
</td>
<td colspan="2">
<label>SAMPLING INITIATED AT:
</label>
<input type="time" id="initSampleTime" name="initSampleName" required>
</td>
<td colspan="2">
<label>SAMPLING ENDED AT:</label>
<input type="time" id="endSampleTime" name="endSampleTime" required>
</td>
</tr>
<tr>
<td colspan="2">
<label>PUMP OR TUBING DEPTH IN WELL (feet):</label>
<input id="pumpDepthWell" name="pumpDepthWell" type="number" min="0" step="0.0001" required>
</td>
<td colspan="2">
<label>TUBING MATERIAL CODE:</label>
<input type="text" id="tubingMaterial" name="tubingMaterial" required>
</td>
<td colspan="2">
<h4>FIELD-FILTERED:</h4>
<label for="yesFiltered">YES</label>
<input id="yesFiltered" type="radio" value="1" name="filtered" checked style="width: 20px;">
<label for="noFiltered">NO</label>
<input id="noFiltered" type="radio" value="0" name="filtered" style="width: 20px;">
</td>
<td colspan="2">
<label>FILTER SIZE (μm):</label>
<input type="number" id="filterSize" name="filterSize" min="0" step="0.0001">
</td>
<td colspan="2">
<label>Filtration Equipment Type:</label>
<input type="text" id="filterType" name="filterType">
</td>
</tr>
<tr>
<td colspan="5">
<h4>FIELD DECONTAMINATION:</h4>
<div class="row">
<div class="col-lg-6">
<h4>PUMP</h4>
<label>YES:</label>
<input type="radio" id="pumpDeconYes" name="deconPump" value="1" checked style="width: 20px;">
<label>NO:</label>
<input type="radio" id="pumpDeconNo" name="deconPump" value="0" style="width: 20px;">
</div>
<div class="col-lg-6" >
<h4>TUBING(replaced)</h4>
<label>YES:</label>
<input type="radio" id="deconTubingYes" name="deconTubing" value="1" checked style="width: 20px;">
<label>NO:</label>
<input type="radio" id="deconTubingNo" name="deconTubing" value="0" style="width: 20px;">
</div>
</div>
</td>
<td colspan="5">
<h4>DUPLICATE</h4>
<label>YES:</label>
<input type="radio" id="duplicateYes" name="duplicate" value="1" checked style="width: 20px;">
<label>NO:</label>
<input type="radio" id="duplicateNo" name="duplicate" value="0" style="width: 20px;">
</td>
</tr>
<tr>
<th colspan="4">
SAMPLE CONTAINER SPECIFICATION
</th>
<th colspan="3">
SAMPLE PRESERVATION
</th>
<th rowspan="2">
INTENDED ANALYSIS AND/OR METHOD
</th>
<th rowspan="2">
SAMPLING EQUIPMENT CODE
</th>
<th rowspan="2">
SAMPLE PUMP FLOW RATE (mL per minute)
</th>
</tr>
<tr>
<th>
SAMPLE ID CODE
</th>
<th>
# CONTAINERS
</th>
<th>
MATERIAL CODE
</th>
<th>
VOLUME
</th>
<th>
PRESERVATIVE USED
</th>
<th>
TOTAL VOL ADDED IN FIELD (mL)
</th>
<th>
FINAL pH
</th>
</tr>
</table>
<div style="text-align: right;">
<a id="addRowS" class="btn btn-default btn-xs">Add row</a>
<input id="numberRowsSam" type="number" style="width: 50px;" min="1" value="1">-
<a id="removeRowS" class="btn btn-default btn-xs">Remove row</a>
</div>
<div>
<h6>REMARKS:</h6>
<textarea style="min-height: 80px;width: 100%;" id="remarks" name="remarks"></textarea>
<p>
<span style="font-weight: bold;">MATERIAL CODES:</span> <span style="font-weight: bold">AG</span> = Amber Glass;<span style="font-weight: bold">CG</span> = Clear Glass;<span style="font-weight: bold">PE</span>= Polyethylene;<span style="font-weight: bold">PP</span>= Polypropylene;<span style="font-weight: bold">S</span>= Silicone;<span style="font-weight: bold">T</span>= Teflon;<span style="font-weight: bold">O</span>= Other (Specify)
</p>
<p>
<span style="font-weight: bold;">SAMPLING EQUIPMENT CODES:</span> <span style="font-weight: bold">APP</span> = After Peristaltic Pump;<span style="font-weight: bold">B</span> = Bailer;<span style="font-weight: bold">BP</span>= Bladder Pump;<span style="font-weight: bold"> ESP</span>= Electric Submersible Pump;
</p>
<p>
<span style="font-weight: bold">RFPP</span>= Reverse Flow Peristaltic Pump;<span style="font-weight: bold">SM</span>= Straw Method (Tubing Gravity Drain);<span style="font-weight: bold">O</span>= Other (Specify)
</p>
<p>
NOTES: 1. The above do not constitute all of the information required by Chapter 62-160, F.A.C.
2. STABILIZATION CRITERIA FOR RANGE OF VARIATION OF LAST THREE CONSECUTIVE READINGS (SEE FS 2212, SECTION 3)
pH: + 0.2 units Temperature: + 0.2 oC Specific Conductance: + 5% Dissolved Oxygen: all readings < 20% saturation (see Table FS 2200-2); optionally, + 0.2 mg/L or + 10% (whichever is greater) Turbidity: all readings < 20 NTU; optionally + 5 NTU or + 10% (whichever is greater)
</p>
</div>
<div class="row">
<div class="col-lg-12 text-center">
<div class="btn btn-lg btn-default" id="saveData">SAVE</div>
<div id="printBtn" class="btn btn-lg btn-default">PRINT/DOWNLOAD</div>
</div>
</div>
</form>
</div>
</body>
</html>