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' B"FfEnvironmental Management,Inc GROUNDWATER SAMPLING FORM71 <br /> 202 East Earll pave,Suite 478 I ��Phoenix,Arizona 850I2 Well No <br /> 602 728-0707 <br /> Well Monito Remedial -VE AS Recovery <br /> Site ct No Well E] PVC St Steel 0 Other <br /> Project Hate (2T _ <br /> n-r?�[f Time <br /> Recorded By Sampled By <br /> WELL PURGING <br /> Purge Volume Purge Date---[_ Purge Method <br /> Casing Diameter(D)in Inches ❑ Bailer-Type <br />' �2-Inch El4-inch El6-inch El Other ,,Submersible El Whale <br /> Total Depth of Casing (TD in feet BTOC) _�2 ❑ Other <br /> Water Level Depth(WL in feet BTOC) Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> I �3 El 4 ❑ 5 Ll Other Near Bottom EJ Near Top El Other <br /> Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from <br /> l <br /> -?-Z — �q 2 J X X 3 f to X 0 0409 = f I ,& gallons <br /> L TD(feet) WL(feet) D(inches) #Vols <br /> Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start Stop Time Elapsed Initial qpm t-( gallons <br /> IField Parameter Measurements Fina! qpm <br /> Time Time Lapsed Gallons Cond 1 Cond 2 <br /> Purged (umhos/cm) (umhoslcm) Temp pH Notes <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 I I ISampling Time _ /0' <br /> 1 Sampling Method Water Level Before Sampling (in feet BTOC) <br /> 1 N Bailer-Type ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Gran-Type <br /> ❑ Other ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> Sample No Containers,Vol # Analysis Preservative Lab Comments <br /> t G� <br /> Other Notes <br />