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BLAES E.wronment.iM.iiagement,Ine GROUNDWATER SAMPLING FORM <br /> ' 1433 North Third Avenue <br /> Phoenix,Arizona 85003 Well No MW-5$ <br /> 02-728-0707 <br /> Well Type ■ Monitor ❑ Remedial -VE AS <br /> ite ID U-Haul #709-50 ❑ Other <br /> Project No 002-70950-04 Well Materia[ ■ PVC ❑ St Steel <br /> Recorded By CIC ❑ Other <br /> ' L. WELL PURGING <br /> Purge VolumePLurge Datef Purge Method <br /> Casing Diameter(D)in inches ❑ Bader-Type <br /> E 2-inch ❑ 4-inch ❑ 6-inch ❑ Other <br /> Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) 72 ❑ Other <br /> Water Level Depth(WL in feet BTOC) L!q 27 Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> 3 El 4 ❑ 5 E3 Other X Near Bottom El Near Top [I Other <br /> Depth in feet(BTOC) <br /> ' Purge Volume Calulation Screen Interval in Feet(BTOC) from 52 <br /> 722(fC <br /> n z to 72 <br /> TO(feet (feet)� X X 3 X 0 0409 = f l) $ ( gallons <br /> ) WI D(inches) #Vols Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start 7 3-0 Stop 7'`(7 Time Elapsed l2 Initial gpm [ gallons <br /> Field Parameter Measurements Final gpm <br /> ' Time Gallons Purged DO% DO(mg1L) Cond 1 Cond 2 Salinity Temp Notes <br /> (umhos/cm) (umhoslcm) <br /> .� <br /> 37 (, 5 S' �D IRD> �b P a 2 t S— <br /> '1 t Z_ 1g 7-VO 0 ,( 7-t C ham_ <br /> 4-q:T 1� 3 q Lt f <br /> 1 Observations During Purging(well Condition,Turbidity Color,Odor,etc <br /> Purge Water Storage/Disposal ❑ Drum(s),Number — E:1 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 /> 1Sampled By r t Sampling Date j"'I 1 q1x-_ Sampling Time 7 3O <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> ' Bailer-Type 3' Disposable - ❑ same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> 1 sampling Distribution= Sample Series <br /> Sample No _ Containers,Vol,# Analysis Preservative Lab Comments <br /> -(1) 1 L Amber 8015 None _-D_lesel __ <br /> MW-58 (3)40mL Voa`s 82130 HCl Oxy's, 1,1-DCA, 1,2-DCA <br /> Other Notes <br />