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BLAES Envl <br /> ronmentalManagement,lnc GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> I Phoenix,Arizona 85003 Well No MW-10C <br /> 502-728-0707 <br /> Well Type ■ Monitor ❑ Remedial -VE AS <br /> Wpite 1D U-Haul #709-50 © Other <br /> IProject No 002-70950-04 Well Material ■ PVC ❑ St Steel <br /> Recorded By Greg Coffin ❑ Other <br /> WELL PURGING <br /> Purge JPurge Date IPurge Method <br /> Casing Diameter(D)in Inches El Bailer-Type <br /> 2-inch E] 4-inch ❑ 6-inch ❑ Other51 <br /> Submersible E] Submersible Whale , <br /> Total Depth of Casing(TD in feet BTOC) ❑ Other <br /> Water Level Depth(WL in feet BTOC) Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> ❑ <br /> 3 ❑ 4 ❑ 5 ❑ Other Near Bottom [:1 Near Top El Other <br /> Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 645 <br /> 2 to 84 5 <br /> 13`3 ::;-V 60 6� X 2 X 3 X 0 0409 = 7-a gallons <br /> TD(Feet) WL(feet) D(inches) #Vols Calculated Purge Volume <br /> Pump Time Purge Rate I Actual Purge Volume <br /> Start Stop Time Elapsed Initial gpm t gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons Purged DO% DO(mglL) Cond 2 Salinity Temp pH Notes <br /> (umhoslcm} (umhoslcm} <br /> r <br /> 4�s® t, l..'f ©.k4p -- - 213.8 — <br /> i <br /> 41S3 19 f 2,6 '0 4 1Y - y F 2,qa <br /> �t (T 16 4, !J.s� 23. $ <br /> I <br /> I t I <br /> Observations During Purging(well Condition, Turbidity, Color,Odor etc A,w, tavr7"a aA , <br /> LJp--r4'ArCsr` <br /> Purge Water Stora /Disposal ❑ Drum(s), Number ❑ Storm Sewer ❑ Sanita Sewer <br />' Other 1 Comments Purge water contained in on-site 1 000 gallon poly tank pending analysis/disposal <br /> WELL SAMPLING <br /> Sampled By -- ,ILI Sampling Date Ili Sampling Tlme <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> Bader-Type rs ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> _ Sample No _ - ; Containers Vol ,# Analysis—� PreservativeLI ab I Comments <br /> M►,�,L.��--- -�_��,.�.�N � mss-- _ -�- I S � �,�� <br /> In PF <br /> Other Notes <br />