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BLAS$EovlroomentalNbruigement,Inc. GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> ' Phoemr,Anzona 85003 Well No <br /> 602 728-0707 <br /> Well Type XMonitor 13 Remedial VE AS <br /> Site ID �`" p�� ❑ Other <br /> ' Project No 00�� 7e j t5 Well Material XPVC C3 St Steel <br /> Recorded By ❑ Other <br /> WELL PURGING —_w-- --- - - - - <br /> Purge Volume Purge Date [Z- -D L_ Purge Method <br /> Casing Diameter(D) in inches <br /> ❑ Bailer Type <br /> DJ�2 inch ❑ 4 inch ❑ 6 inch ❑ Other Submersible ❑ Submersible whale <br /> Total Depth of Casing(TD in feet 7t4 a ❑ Other <br /> Water Level Depth(WL in feet BTOC) dPump Intake Setting J <br /> ' Number of Well Volumes(#Vols)to be ��/�" <br /> ❑ 4 [15 11 Other cKEl Bottom Near Top ❑ Other <br /> Depth in feet(BTOC) :?Qr <br /> Purge Volume Calufation Screen Interval in Feet(STOC) 5-2- <br /> 77 <br /> -71 00 �2 — � {� to <br /> TD(feet) wL X X X 0 0409 = O-U gallons <br /> (inches) #Vols Calculated Purge Volume <br /> ' Pump Time Purge hate Actual Purge Volume <br /> Start 11J0 Stop f 0l Time 5 ('" ^ Initial gpm <br /> �— gallons <br /> Field Parameter Measurements ! gpm <br /> — �Gallons Cond 1 _ Gond 2 <br /> Time Time Lapsed I SalinityNotes <br /> Purged (umhos/cm) (umhos/cm) i Temp <br /> � I <br /> Observations During Purging(well Condition, Turbidity, Calor Odor, <br /> Purge Water Storage/Disposal ❑Drum(s), Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> ' Other/Comments _—B-f T4-c I I --Q �f«It,L_ _ --j�w_ _ <br /> WELL. SAMPLING <br /> Sampled By }L� _ Sampling Date JZ- S—O Z Sampling Time <br /> ' Sampling Method Water Level Before Sampling(In feet BTOC) -7`ilu L <br /> D53ailer Type Zf ❑ Same as Above <br /> ❑ Submersible ❑ Whale )Grab Type <br /> ❑ Other ❑ Other Type i <br /> Sampling Distribution Sample Series <br /> ' Sample No Containers, Vol ,# Analysis Preservative Lab Comments <br /> I <br /> Other Notes l <br />