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BLAES Env&anmentaiManagement,Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> Phoenix,Arizona 85003 Well No MW-11 B <br /> 02-728-0707 <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 /> L WELL PURGING ! <br /> Purge Volume Purge Date 3 S- o- Purge Method <br /> Casing Diameter(D)in inches P ire <br /> 2-inch ❑ 4-inch ❑ 6-inch ❑ Other <br /> Y]I�• <br /> Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) 60 ❑ Other <br /> Water Level Depth(WL in feet BTOC) 5-11 z Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged L1 Near Bottom [:] [INear Top Other <br /> 3 [—] 4 115 ❑ Other <br /> Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 40 <br /> z to sa <br /> 60 _ � Z 1 X 2 X 3 X 0 0409 = .3, �(�- gallons <br /> TD(feet) WL(feet) J D(inches) #Vols Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start Stop y r' Time Elapsed Initial gpm y p gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons Purged DO°/ Dp(mg1L) Gond 1 Cond 2 Salinity Temp Nates <br /> (umhoslcm) (umhoslcm) <br /> `,�'-37 Z �S 3 `�,0 V 13yo I qS_0 0 2-to <br /> 10 1311 1ggj �' � 2I, 1 <br /> Observations During Purging(well Condition Turbidity,Color,Odor,etc ) j1.} G t a or <br /> I <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 analysis/disposal <br /> WELL SAMPLING <br /> Sampled By= 4e- ISampling DISampling Time L _ <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 /> Sampling Distribution sample series I - _------ <br /> Sample No Containers,Vol,# Analysis -Preservative Lab-- , Comments _ <br /> (1) 1 L Amber _ 8015 _ None Diesel <br /> i <br /> MW-11 B __ (3)40mL Voa's _ 8_015 HCI Se ! Gasoline_ _q BTEX, Fuel <br /> (3)40mL Voa's 8260 HCI Y <br /> --_ -- - - - - - - - --- - ----� - - �T DCA, 1,2-DCA <br /> Other Notes <br />