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BLAES Environmentatl 2nagement,lnc GROUNDWATER SAMPLING FORM <br /> 1433 Forth Third Avenue <br /> Phoenix,Arizona 85003 Well No MW-12C <br /> 602-728-0707 <br /> Well Type ■ Monitor ❑ Remedial -VE AS <br /> Site ID _g-Haul #709-50 ❑ Other <br /> Project No 002-70950-04 Well Material ■ PVC ❑ St Steel <br /> Recorded By Greg Coffin ❑ Other <br /> i WELL PURGING <br /> Purge Volume Purge Date Purge Method <br /> Casing Diameter(D)in inches &I Bailer-Type _j2'.>S i' PVC. <br /> 0 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 /> Number of Well Volumes(#Vols)to be Purged <br /> ❑ Near Bottom El Near Top El Other <br /> E3 ❑ 4 ❑ 5 ❑ Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(STOC) from 65 <br /> C <br /> l to 85TD(feet) WL(feet) D(inches) #Vols-in S-4 � �r7 SVJ X 2 2 3 X X 0 0409 = /ca 167 gallons <br /> Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start 40.-r$_ Stop - Time Elapsed P Initial gpm gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons Purged DO% DO(mg1L) (uCond m) (uCond m) Sahnity Temp pH Notes <br /> - /- 76 24"/ a <br /> 9 /-7 /6,a� a, ..j/y7�'✓ 2.01-1 <br /> I I <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 analysis/disposal <br /> WELL SAMPLING <br /> SampledBy Sampling Date--] //c/y Sampling Time 19-'so <br /> Sampling Method Water Level Before Sampling(in feet BTOC) 16127 <br /> Bailer-Type -3' S �C ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> Sample No� - _ _Containers,Vol ,# AnalysisPreservative __-Lab i Comments <br /> L -„�. -e.r_ <br /> -- _ V0r4 <br /> Other Notes <br />