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BLACJ EmiranmentatManagement,Inc GRQUNDWATBR SAMPLING FORM <br /> 1433 North Third A%enue <br /> Phoenix,Arizona 85003 Well No ��� <br /> 603 723 0707 <br /> >tte ID U-Haul #709-50 Wefl Type ■ Monitor E] Remedial -VE AS <br /> E] Other <br /> Project No 002-70 950-03 Well Material In PVC ElSt Steel <br /> Recorded BY___E McDaniel ❑ Other <br /> WELL PURGING <br /> Purge Volume Purge Date bl Purge Method <br /> Casing Diameter(D)in inches El Bailer-Type <br /> 2-inch [:14-inch ❑ 6-inch C] Other Submersible <br /> ❑ Whale <br /> Total Depth of Casing(TD in feet BTOC) 7, Other Z Ire <br /> Water Levet Depth (WL in feet BTOC) <br /> Number of Well Volumes(#Vols)to be Purged Pump Intake Setting <br /> ❑ Near Bottom El Near Top El Other l <br /> 3 El 4 [_1 5 IJ Other Depth in feet(BTOC) –G— Zo <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from <br /> 7 _ 2 to <br /> TO{(feet) t�t) X X X 0 0409 gallons <br /> (inches) #Vols <br /> Caiculated Purge Volume <br /> Pump Time Purge Rate lActual Purge Vofurne <br /> Start O Stop I to Time ElapsedGC� Initial 2 qpm gallons <br /> Field Parameter Measurements Final qpm <br /> Time Time i apsed Gallons ccrid 1 Cond 2 <br /> Purged (umhos/cm) (umhos/cm) Temp Notes <br /> Il zz_ 2� b�z7 Zz .L4 <br /> Observations During Purging(well Condition,Turbidity, Color Odor,etc <br /> Purge Water Storage/Disposal ❑Drum(s), Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> Other <br /> WELL SAMPLING <br /> Sampled By B McDaniel ISampling Date_ ISampling Time <br /> Sampling Method Water Level Before Sampling(in feet BTOC) 5r7 c:nO <br /> ® Bader-Type 3 f# Disposable ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other <br /> ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> Sample No Containers Vol,m Analysis Preservative Lab Comments <br /> Other Notes <br />