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;t433 <br /> LAES Environmental Managernent,Joe GROUNDWATER SAMPLING FORM <br /> North Third Avenue <br /> oenix,Araona 85003 Well NO MW-12B <br /> 2-728-0707 <br /> Well Type ■ Monitor ElRemedial-VE AS <br /> te ID U-Haul#709-50 ❑ Other <br /> Project No 002-70950-04 Well Material ■ PVC ❑ St Steel <br /> Recorded By 'Q ❑ Other <br /> WELL PURGING <br /> (Purge Volume Pru ge Date �i Purge Method <br /> Casing Diameter(D)in inches6' PVC <br /> Bailer-Type <br /> 0 2-inch ❑ 4-inch ❑ 6-inch ❑ Other ❑ Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) 60 ❑ 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 /> ■ 3 ❑ 4 ❑ 5 ❑ Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 40 <br /> 2 to 60 <br /> 60 — �J X 2 X 3 X 0 0409 = 1f, 0-S— gallons <br /> ITD(feet) WL(feet) D(inches) #Vols Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start-12.31Stop Z�3t Time Elapsed Initial gpm L gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons Purged DO% DO(mg1L) Cond 1 Cond 2 Salinity Temp Notes <br /> (umhoslcm) (umhos/cm) 7 <br /> Observations During Purging(well Condition,Turbidity,Color,Odor,etc <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 analysisidisposal <br /> WELL SAMPLING <br /> 1Sampled By ISampling Date 1 -3//S oS Sampling Time oQ <br /> Sampling Method Water Level Before Sampling(in feet STOC) <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-128 _( )�OmL Voa's 8_015 HCI Seq Gasoline __ <br /> (3)40mL Voa's 8260 HCI BTEX, Fuel Oxy's, 1,1- <br /> I DCA, 1,2-DCA <br /> Other Notes <br />