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BLAES Env[roamental Management,Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> 4Phoen�x,Arizona 85003 Well No MW-5C <br /> OZ-728 Ari <br /> 707 Well Type ■ Monitor ❑ Remedial -VE AS <br /> ' Site ID U-Haul #709-50 ❑ Other <br /> Project No 002-70950-04 Well Material ■ PVC ❑ St Steel <br /> Recorded By ❑ Other <br /> _ WELL PURGING <br /> Purge Volume J Purge Date f Purge Method <br /> Casing Diameter(D)in inches ❑ Bader-Type <br /> N 2-inch ❑ 4-inch [] 6-inch ❑ Other <br /> � Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) 90 ❑ Other <br /> ' Water Level Depth(WL in feet BTOC) <br /> Number of Well Volumes(#Vols)to be Purged Pump Intake Setting- <br /> Near Bottom E] Near Top ❑ Other <br /> 3 ❑ 4 [3 5 1:1 Other Depth in feet(BTOC) <br /> ' Purge Volume Calulation Screen Interval In Feet(BTOC) from 70 <br /> 90 — sv q 0 2 2 3to 90 <br /> TD(feet) WL(feet) X D(orches) X #Vols X 00409 - J ��� gallons <br /> Calculated Purge Volume <br /> Pump Time IPurge Rate JActual Purge Volume <br /> ' Start -7 Sb Stop Time Elapsed Initial gpm 'Zp gallons <br /> Field Parameter Measurements Final gpm <br /> - --- --J <br /> Time Gallons Purged DO% DO(mg/L) Cond 1 Cond 2 Salinity Temp Notes <br /> (umhos/cm) (umhos/cm) <br /> 7 ra-7 `es J!7 U t{ 2' T C l'L_' IV, to <br /> 2Z 7`rb s100 t7 `t' Z' L <br /> b% 7'?Ie �!�t d-`i <br /> t Z..a t %2 , l YI 7 4q his+ v q 7-t L <br /> 1 <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 analysts/disposal <br /> WELL SAMPLING <br /> Sampled By J mpling Date (s DS Isampling Time -7 <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> ' N Bailer-Type 3` Disposable_ __ ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> Sample No Containers,Vol,# Analysis Preservative Lab Comments _ <br /> (1) 1 L Amber 8015 None I Diesel _ _- <br /> MW-5C (3)40mL Voa's 8260 HCl Seq Gasoline, BTEX, Fuel <br /> Oxy's, 1,1-DCA, 1,2-DCA <br /> Other Notes <br />