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BaLAE$ Management,Inc GROUNDWATER SAMPLING FORM <br /> ' 1433 North Third Avenue <br /> Phoenix,Arizona 85003 Well No MW-11C <br /> 02-728-0707 <br /> Well Type ■ Monitor ❑ Remedial-VE AS <br /> Site Ip U-}caul #709-50 ❑ Other <br /> Project No 002-70950-04 Well Material ■ PVC ❑ St Steel <br /> Recorded By Sw _ ❑ Other <br /> WELL PURGING <br /> Purge Volume f Purge Date 3 S- cs JPurge Method <br /> Casing Diameter(D)in inches p ' <br /> E 2-inch ❑ 4-inch ❑ 6-inch [] Other Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) 85 ❑ Other <br /> Water Level Depth(WL in feet BTOC) S1 _2- <br /> Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> ❑ Near Bottom ❑ Near Top ❑ Other <br /> ■ 3 ❑ 4 ❑ 5 ❑ Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 65 <br /> l z to 85 <br /> 8(f — S` Z J X 2 X 3 X 0 0409 = 14,33 gallons <br /> TD(rest) WL(feet) J D(inches) #Vols Calculated Purge Volume <br /> Pump Time Purge RateActual Purge Volume <br /> 1 Start q,1 Stopq 3? Time Elapsed Initial gpm gallons <br /> - --- ---- 1 <br /> Field Parameter Measurementsmerits Finagpm <br /> Time Gallons Purged DO% DO(mg/L) Cond 1 Cond 2 Salinity Temp Notes <br /> (umhoslcm) (umhoslern) <br /> LZ U 5- 1155 I2-C5' c' ZC 3 <br /> Y 46 . I 21.1.19 1337 lg65- ZcS <br /> ri 3c z IS 33 , x- 3 01 13` 3 IVES 0 2C,6 <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 analysisldisposal <br /> WELL SAMPLING <br /> Sampled By _Ge- Sampling Date - -o Sampling Time �Si X15;_ r <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 - <br /> Sample No Containers,Vol # Analysis Preservative Lab Comments <br /> (1) 1 L Amber 8015 None Diesel <br /> MW-11C _(3)40mL Voa's 8015 HCI Se Gasoline <br /> q <br /> (3)40mL Voa's 8260 HCl BTEX, Fuel Oxy's, 1,1- <br /> DCA, 1,2-DCA <br /> Other Notes <br />