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BLAES EnvironmentaiManagement,Inc GROUNDWATER SAMPLING FORM <br /> ' 1433 North Third Avenue <br /> Phoenix,Arizona 55003 Well NO MW-813 <br /> z-na-o7ny <br /> Well Type ■ Monitor 113 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 Gren Coffin ❑ Other <br /> ' WELL PURGING <br /> Purge Volume Jurge Date Purge Method <br /> ' Casing Diameter(D)in inches ElBailer-Type <br /> E] 2-inch ■ 4-inch ❑ 6-Inch ❑ Other N Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) 62 ❑ Other <br /> ' Water Level Depth(WL in feet BTOC) Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> Near Bottom [:1 Near Tap ❑ Other <br /> E 3 ❑ 4 1:15 ❑ Other Depth in feet(BTOC) <br /> ' Purge Volume Calulation Screen Interval in Feel(BTOC) from 37 <br /> 62 -- - - f Cft- 4 2 3 /h' 3� to 62 <br /> TD feet WL feet X_ X X 0 0409 = gallons <br /> (feet) (feet) D(inches) #vols Calculated Purge Volume <br /> Pump Time Purge Rate _ Actual Purge Volume <br /> Start 2'.Z9 Stop Time Elapsed Initial gpm 5 gallons <br /> ' Field Parameter Measurements Final gpm <br /> Time Gallons Purged DO% DO(mglL) Cond 1 Cond 2 Salinity Temp Notes <br /> (umhoslcm) (umhoslcm) <br /> Z 38 i0 17- 1 �?9s Zi s- <br /> 2- <br /> 2- YL Z 15 io I o,`la" 1-31-113 1370 o -?1- 217 <br /> Observations During Purging(well Condition,Turbidity, Color,Odor,etc <br /> r <br /> ' Purge Water Storage/Disposal ❑ Drum(s) Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> Other 1 Comments Purge water contained in on-site 1,000 gallon poly tank pending analysis/disposal <br /> WELL SAMPLING <br /> 1 Sampled By .erP, ISampling Date J 3/L <br /> Sampling Time <br /> Sampling Water Level Before Sampling(in feet BTOC) <br /> ' E Bailer-Type 3' Disposable - ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> _ <br /> Sample No Containers,Val,# Analysis Preservative_ _ Lab I Comments <br /> (1) 1 L Amber 8015 None - Diesel <br /> ' MW-8A _(3)40mL Voa's 8015 HCI_ ____ Seq _ Gasoline _ <br /> � <br /> (3)40mI3TEX, Fuel Oxy's,L Voa's 8260 HCI __DCA, 1,2-DCA _ <br /> Other Notes �' <br />