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BLAES Environmental GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> Phoenix,Arizona 85003 Well No MW-4C <br /> 602-728-0707 <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 Grecl Coffin ❑ Other <br /> I L_ YVELL PURGING <br /> Purge Volume JPurge D__a_te__7 Purge Method <br /> Casing Diameter(D)in inches ❑ Bailer-Type <br /> I0 2-inch ❑ 4-inch ❑ 6-inch ❑ Other ( Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) ❑ Other <br /> Water Level Depth(WL in feet BTOC) Pump Intake Setting <br /> I Number of Well Volumes(#Vols)to be Purged ❑ Near Bottomp [_1 Other <br /> ❑ Near To <br /> E 3 ❑ 4 ❑ 5 ❑ Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 68 <br /> z to 88 <br /> 1( �48 L-t 'V J X 2 X 3 X 0 0409 = i 2 01 gallons <br /> TD{feet) WL(feet} J D(inches) #Vols Calculated Purge Volume <br /> IPump Time IPurge Rate Actual Purge Volume <br /> Start /SSZ StOP15S Time Elapsed Initial gpm l2 gallons <br /> Field Parameter Measurements_ I Final gpm <br /> Time Galions Purged DO% DO(mg/L) Cand 1 Cond 2 Salinity Temp pH Notes <br /> (umhos/cm) (umhoslcm) <br /> 0,76 Z.3. 0 <br /> 11156-7 S IV,It d,7e 2`" <br /> I //, / �-j 2 <br /> Observations During Purging(well Condition,Turbidity,Color, Odor etc <br /> Purge Water Storage/Disposal ❑ Drum(s),Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> I <br /> Other/Comments Purge water contained in on-site 1,000 gallon poly tank pending analysis/disposal <br /> WELL SAMPLING <br /> Sampled By I I ISampling Date qld Sampling Time <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> Bailer-Type '�:)F vr.-�LL ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> Sampling Distribution Sample series <br /> Sample No Containers,Vol,## - I Analysis Preservative I Lab _Comments <br /> Other Notes <br />