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--------------- <br /> B LAFJEnvironmental Management,int GROUNDWATER SAMPLING FORM <br /> 202 East Earl].Drive,Suite 478 ((�� }� Y <br /> Phoenix,Arizona 85012 Well NO (AJ "�1 <br /> 602 728 0707 l <br /> Well Type El Monitor 1] Remedial-VE AS Recovery <br /> Site 1D _ Well Material EJ PVC © St Steel Ll Other <br /> Project No Date Time <br /> Recorded By Sampled By <br /> — _ WELL PURGING <br /> Purge Volume P u rg_e_D_a_te___j jPurge Method <br /> Casing Diameter(D)in inches ❑ Bailer-Type <br /> ❑ 2-Inch ❑ 4-inch ❑ 6-Inch ❑ Other ❑ Submersible ❑ Whale <br /> Total Depth of Casing(TD in feet BTOC) ��_ZU ❑ Other <br /> Water Level Depth(Wl-in feet BTOC) 0 3 <br /> Number of Well Volumes(#Vols)to be Purged Pump Intake Setting <br /> El 3 ❑ 4 E] 5 ❑ Other EJ Near Bottom El Near Top El Other <br /> Depth in feet(BTOC) <br /> r Purge Volume Calulation Screen Interval in Feet(BTOC) from <br /> I r _ 2 to <br /> L TD(feet) WL feet X X X 0 0409 = gallons <br /> ` ( ) D(inches) #Vols Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volum <br /> Start Stop Time Elapsed Initial gpm gallons <br /> Field Parameter Measurements Final gpm <br /> Time Time Lapsed Gallons Cond 1 Cond 2 <br /> Purged (umhoslcm) (umhostcm) Temp pH Notes <br /> 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 <br /> WELL SAMPLING <br /> Sampling Date IZ-q -&L_ jSampillnq_T_im_e__j I T j <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> ❑ Bailer-Type ❑ Same as Above <br /> ❑ Submersible ❑ Whale <br /> ❑ Other ❑ Grab-Type <br /> ❑ Other-Type <br /> Sampling Djstrjbutj2E___j Sample Series <br /> Sample No <br /> CAnalysis Preservative Lab Comments <br /> I <br /> Other Notes <br />