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Saes. - <br /> gIA* FJEnvironmental Management,Inc GROUNDWATER SAMPLING FORM <br /> 202 East Earll Drive,Suite 478 r <br /> Phoenix,Arizona 85012 Well No W —�I <br /> 602 728-0707 <br /> Well Monito Remedial -VE AS Recovery <br /> Site ID Well 0 PVC 0 St Steel 0 Other <br /> Project No '2 Date Z-'7 Time <br /> Recorded By Sampled By <br /> WELL PURGING <br /> Purge Volume JPurge Date --L__ Purge Method <br /> Casing Diameter(D)in inches ❑ Bailer-Type <br /> I 2-Inch ❑ 4-inch ❑ 6-inch ❑ Other Submersible ❑ Whale <br /> it otal Depth of Casing(TD in feet BTOC) �y y� ,j r7 ❑ Other <br /> Water Level Depth(WL in feet BTOC) Pump Intake Setting <br /> I Number of Well Volumes(#Vols)to be Purged 92 <br /> Near Bottom El Near Top ❑ Other <br /> [9 3 ❑ 4 El 5 ❑ Other <br /> epth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from <br /> r l2 to <br /> X X � X 0 0409 = �• gallons <br /> `\ (feet)WL D(inches) #Vols <br /> TD(feel) Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start S Stop _ Time ElapsedInitial qpm zo gallons <br /> Field Parameter Measurements Final qpm <br /> Time Time Lapsed Gallons Cond 1 Cond 2 <br /> p Purged (umhos/cm) (umhoslcm) Temp pMT Notes <br /> Observations During Purging(well Condition,Turbidity,Calor,Odor,etc <br /> Purge Water Storage/Disposal Drum(s),Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> Other <br /> WELL SAMPLING <br /> Sampling Date 1 l 7--to Sampling Time <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> Bailer-Type ❑ same as Above <br /> Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> Sample No Containers,Vol,# Analys:s Preservative Lab Comments <br /> Other Notes <br />