School Name:

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Site Name:

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Test Date (mm/dd/yyyy):

Date Missing

Test time (--:-- --):

Ambient Temperature (°C):

Water Temp @ Site (°C):

Water Temp Upstream (°C):

Weather and Other Notes:

Invalid Test Data

WQI Data Summary Form
Test Name	Field Data		Units	Q-ValueFrom Graphs	Weighting Factor	Total Value
Dissolved Oxygen			mg/L		0.17
			% Sat
Fecal Coliform			Colonies / 100mL		0.16
pH			Units		0.11
B.O.D.			Old mg/L (tested @ river)		0.11
			New mg/L (after 5 days)
			Difference
Temperature			Delta (°C)		0.10
Phosphate			mg/L (PO4) GM Total Phospahate Concetration		0.10
			ppm (O-PO4) Othphosphate from Field
Nitrates			mg/L (NO3-N) Field Data		0.10
	x 4.4 =		mg/L (NO3)
Turbidity			JTU's		0.08
Total Solids			mg/L		0.07
				Total WQI Value Sum:
				Total Weighted WQI Value: