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BLAES EnvironraentaiMaaagement,Inc GROUNDWATER SAMPLING FORM <br /> ' 1433 North Third Avenue <br /> Phoenix,Arizona 85003 Well No MW-5C <br /> jMW6fl2-72H-(17f17 <br /> Well Type ■ Monitor 0 Remedial-VE AS <br /> Site Ib U-Haul #709-50 ❑ Other <br /> Protect No 002-70950-04 Well Material ■ PVC ❑ St Steel <br /> Recorded By 0 Other <br /> ' WELL PURGING <br /> Purge Volume Purge Date 5- Purge Method <br /> Casing Diameter(D)in inches <br /> L:1 Sailer-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) Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged ■ Near Bottom ❑ Near Top ❑ Other <br /> E 3 ❑ 4 ❑ 5 ❑ Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 70 <br /> 2 to 90 <br /> 90 — 5 Z s z 2 3 X 0 0409 = <br /> TO feel WL feet J X X 1$_`�0 gallons <br /> ' (feet) (feet) 0(inches) #Vols Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start, <br /> � � Stop �_ Time Elapsed Initial gpm Zc3 gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons Purged DO% DO(mg/L) (uCondlcd 1 {uCond m) Salinity Temp Notes <br /> 3 0. 3J >/, y C(mow ilo ©d'o <br /> 0,16 -- - ZI, 7- ., <br /> 0tt21, 1 r, It <br /> ILI ( 3 Zu k , <br /> i <br /> Observations During Purging(well Condition,Turbidity, Color,Odor,etc <br /> Purge Water StoragelDisposal ❑ 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 G-C IC-4 ISampling Date To Sampling Time <br /> Samplmg Method Water Level Before Sampling(in feet BTOC) <br /> Bailer-Type 3' Disposable ❑ same as Above <br /> ' ❑ Submersible ❑ Whole ❑ Grab-Type <br /> ❑ Other El Other-Type <br /> Sampling Distribution Sample Senes <br /> Sample No a _T Containers,Vol,# Analysis �_ Preservative Lab Comments <br /> I _(1) 1L Amber 8015 _None _ Diesel <br /> MW-5C __ (3}40mL Voa's_ _ 8015_ -HCI Se € Gasoline <br /> ' (3)40mL Voa's 8260 HCI Q BTEX, Fuel Oxy's, 1,1- <br /> -- -- —---- ------ -— -��I L DCA, 1,2-DCA <br /> Other Notes <br /> Os <br />