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BLAES EnviroamentaiManagement,Iae GROUNDWATER SAMPLING FORM <br /> ' 1433 North Third Avenue <br /> Phoenix,Arizona 85003 Well No MW-613 <br /> 602-728-0707 <br /> Well Type ■ Monitor ❑ Remedial-VE AS <br /> ' <br /> Site 1D U-Haul#709-50 ❑ Other <br /> Protect No 002-70950-06 Well Material ■ PVC ❑ St Steel <br /> Recorded By C—) ❑ Other <br /> ' WELL PURGING <br /> Purge Volume Purge:7Date JPurge Method <br /> Casing Diameter(D)in inches _ ❑ Bailer-Type <br /> E 2-inch [] 4-inch [] 6-inch 0 Other E Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) 72 ❑ Other <br /> ' Water Level Depth(WL in feet BTOC) 6 v �� _ Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> 0 Near Bottom ❑ Near Top El Other <br /> 0 3 [:14 ❑ 5 ❑ Other Depth in feet(BTOC) ~65 <br /> ' Purge Volume Calulation Screen Interval in Feet(BTOC) from 52 <br /> to 72 <br /> 72 — �� o 2 2 X 3 X 0 0409 = S gallons <br /> ' TD(feet) WL(feet) X D(inches) #Vols Calculated Purge Volume <br /> Pump Time Purge Rate J Actual Purge Volume <br /> ' start /L zr Stop 11,124 Time Elapsed Initial gpm p gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons Purged) DO% DO(mg]L) Cord t Cond 2 Salinity Temp Notes <br /> (umhoslcm) (umhWcm) <br /> z3 7- Ili u 73 ( 1 63 11 b U z3 7 <br /> r � zb �( � � o 06 zZ.a <br /> Observations During Purging(well Condition,Turbidity,Color,Odor,etc <br /> Purge Water Storage/Omposal [] Drum(s) Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> ' Other 1 Comments Purge water contained in on-site 1,000 gallon poly tank pending analysisidisposal <br /> WELL SAMPLING <br /> Sampled By GC ISampling Date--] JSampling Time ( � <br /> Sampling Method Water Level Before Sampling(in feet BTOC) N <br /> Bailer-Type 3' DIS usable ❑ Same as Above <br /> ' ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> ' Sampling Distribution Preservative Sample Series _ ,-_- _ -- <br /> Sample No ! Containers,Vol,# Wi Analysis Lab Comments <br /> (1) 1 L Amber _ 8015 _Diesel <br /> MW-6B I (2)40mL Amber Voa's;_ _��_ I Gasoline <br /> ' — HCI ESC BTEX Fuel Oxy's, 1,1- <br /> �_ (2)40mL Amber Voa's— —8260 -- --- ;� DCA, 1,2-DCA-- <br /> Other Notes <br />