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1 <br /> L <br /> ES EnvlronmentalManagemenyloe GROUNDWATER SAMPLING FORM <br /> th Third Avenue <br /> Arizona 65003 Well No MW-3Bo7o7 <br /> 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 urge Date ; 3 (o 05- Purge Method <br /> ' Casing Diameter(D)in Inches ❑ Bailer-Type <br /> ■ 2-Inch ❑ 4-inch ❑ 6-Inch ❑ Other <br /> Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) 77 ❑ Other <br /> Water Level Depth(WL in feet BTOC) Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged Near Bottom NearTop El Other <br /> 3 ❑ 4 ❑ 5 ❑ Other Depth in feet(BTOC) <br /> ' Purge Volume Calulation Screen Interval in Feet(BTOC) from 52 <br /> \ z to 77 <br /> 77 `` J X 2 X 3 X 0 0409 = EI gallons <br /> ' TD(feet) WL(feel) D(inches) #Vols Calculated Purge Volume <br /> Pump Time I JPurge Rate Actual Purge Volume <br /> Start j0; Stop jd; Time Elapsed Initial gpm gallons <br /> ' Final gpm <br /> Field Parameter Measurements <br /> I Time Gallons Purged DO% DO(mglL) Cond 1 Cond 2 Salinity Temp Notes <br /> (umhoslcm) (umhoslcm) <br /> (� q(0 Z('� ll s�r�rl d <br /> Z 01 Z3 ---r 2-l __� II ) <br /> Observations During Purging(well Condition Turbidity,Color,Odor etc <br /> Purge Water Storage/Disposat ❑ 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 laySti-- Sampling Date 1 31,4105- Sampling Time <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 Distribution I Sample Series _-- <br /> Sample No Containers,Vol,# Analysis- PreservativeLab_ _ __ Comments_ <br /> (1) 11_Amber 8015 None - - Diesel_T <br /> I , MW-3B _ (3)40mL Voa's - 8_015 _ HCI �, $eq _ Gasoline <br /> (3)40mL Voa's 8260 HCI BTEX, Fuel Oxy's, 1,1-- <br /> --- - - -- -- ---y - ---- -- --- ---- -- - - - -- ---- — �_ DCA, 1,2-DCA <br /> ' Other Notes <br />