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BLAES Environmental Management,Inc GROUNDWATER SAMPLING FORM <br /> I433 North Third Avenue <br /> I Phoenix,Arizona 85003 Well No MW-11C <br /> 602-728-0707 <br /> Well Type ■ Monitor ❑ Remedial-VE AS <br /> ite ID U- aul #709-50 ❑ Other <br /> IProject No 002-70950-04 Well Material ■ PVC ❑ St Steel <br /> Recorded By Greg Coffin ❑ Other <br /> I WELL PURGING <br /> Purge Volume iPurge DateI Purge Method <br /> Casing Diameter(D)in inches [Z Bader-Type bK ( ' ?VI- <br /> M 2-inch ❑ 4-inch ❑ 6-inch ❑ Other <br /> ❑ Submersible E] Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) -bt `t5 ❑ Other <br /> Water Level Depth(WL in feet BTOC) ke0 I Pump} Intake Setting Number of Well Volumes(#Vols)to be Purged - -- <br /> [I Near Bottom L:1 Near Top E:1 Other <br /> 0 3 ❑ 4 ❑ 5 ❑ Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 65 <br /> l 2 to 85 <br /> S' yS 61)`8- J X 2 X 3 X 0 0409 = f U t tp gallons <br /> TD{foet) WL(feet} J D(inches) #Vols Calculated Purge Volume <br /> Pump Time — IPurge Rate JACtual Purge Volume <br /> Start 11 W�b Stop Time Elapsed Initial gpm (p gallons <br /> Field Parameter Measurements Final qpm <br /> Time Galfons Purged DO% DO(mg1L) Cond 1 Cond 2 Sahnity Temp pH Notes <br /> (umhoslcm} {umhoslcm) <br /> 00, <br /> /d Do i u 2-7. <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 analysis/disposal <br /> WELL SAMPLING <br /> Sampled By J„� Sampling Date q g p-T [Sampling Time <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> Bailer-Type / ' Y- ❑ 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 /> W_ tic <br /> ,gym , - s <br /> Other Notes <br />