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1 <br /> BLAES Environmental Management,Inc GROUNDWATER SAMPLING FORM <br /> ' 1433 North Third Avenue MW-5C <br /> Phoenix,Arizona 85003 Well No <br /> 602-728-0707 <br /> Well Type ■ Monitor 11Remedial-VE AS <br /> ' Site ID U-Haul#709-50 ❑ Other <br /> Project No 002-70950-06 Well Material ■ PVC ❑ St Steel <br /> Recorded By SSC © Other <br /> WELL PURGING <br /> Purge Volume I JPurge Date g.* (Lr Purge Method <br /> ' Casing Diameter(D)in inches ❑ Bader-Type <br /> E 2-inch ❑ 4-inch ❑ 6-inch ❑ Other Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) 90 ❑ Other <br /> ' Water Level Depth(WL in feet BTOC) .7--Tt�, Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> Near Bottom El Near Top El Other <br /> 0 3 ❑ 4 ❑ 5 ❑ Other Depth in feet(BTOC) '-80 <br /> ' Purge Volume Calulation Screen Interval in Feet(BTOC) from 70 <br /> 2 to 90 <br /> 90 — 5-5, �o -) 2 X 3 X 0 0409 = i� +�� gallons <br /> TD(feet) WL{feel) X D(inches) #Vols Calculated Purge Volume <br /> Pump Time I JPurge Rate Actual Purge Volume <br /> ' Start I?'91t Stop 'F' %3 Time Elapsed r'4 -- Initial gPm /r S gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons Purged' 00% DO(mglL) (uCond m) (umhosCond ) Salinity Temp Notes <br /> O '-tt-7 X7-7 <br /> Observations During Purging{well Condition,Turbidity,Color,Odor,etc <br /> Purge Water Storage/Disposal ❑ Drum(s) Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> Other/Comments Purge water contained in on-site 1,000 gallon poly tank pending analysis/disposal <br /> WELL SAMPLING <br /> ' Sampled By <br /> C,L4 Sampimg Date S 3') 05` ISampling Time l3 411 <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> 0 Bailer-Type _ 3' Disposable _ ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> ' Sampling Dsstribution -- — Sample series - — -- v— __ <br /> Sample No Containers,Val ,# Analysis Preseryati=ve Lab Comments <br /> (1) 1 L Amber i8015 I ,_ _ Diesel �— <br /> (2)40mL Amber Voa' HCl ESC Gasoline <br /> MW-5C BTEX, Fuel Oxy's, 1,1- <br /> 1 (2)40mL Amber Voa's I 8260 DCA, 1,2-DCA <br /> ' Other Notes <br />