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BLAES EimroumentaiManagement,Inr- GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue' '7 Phoenix, 85003 Well No Z <br /> 602-7Zs-0707 <br /> Well Type WMonitor ❑ Remedial VE AS <br /> Site ID ❑ Other <br /> ' Project Na 4Z „ 70150 J u 3 Well Material XPVC ❑ St Steel <br /> Recorded By ❑ Other <br /> WELL PURGING ---- -- -- ---- - - <br /> Purge Volume Purge Date I L_ �- G Purge Method <br /> Casing Diameter(D) in inches ❑ Bailer Type <br /> ' X2 Inch [] 4 inch ❑ 6 inch [] Other 'Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet ❑ Other <br /> Water Level Depth(WL In feet BTOC) JPump Intake Setting I <br /> ' Number of Well Volumes(#Vols) to be <br /> ,�,/ :Near Bottom [I Near Top C1 Other <br /> Ian 3 ❑ 4 ❑ 5 ❑ Other Depth in feet(BTOC) 72 <br /> Purge Volume Catulation Screen Interval in Feet(BTOC) Z <br /> ' to �� <br /> 75 ? f I I ) X 2 z X X 0 0409 = gaiIons <br /> TD(teat) WL D(inches) At vols Calculated Purge Volume <br /> `Pump Time Purge Rate Actual Purge Volume <br /> Start Is 2z Stop rD—Z'S-Time SJ Initial gpm gallons <br /> --Final — Z- -Rpm <br /> - - - <br /> Field Parameter Measurements <br /> Gallons Cond 1 Cond 2 <br /> Time Time Lapsed I Salinity ; Temp i Notes <br /> ' --- - � Purged- - (umbos/cm)-—(umbos/cm) - <br /> I <br /> Observations During Purging(well Condition, Turbidity, Color, Odor, <br /> I <br /> Purge Water Storage/Disposal ❑Drum(s), Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> ' Other/ Comments ©+t I zrH (ta--", 4- <br /> WELL SAMPLIN <br /> Sampled By _ Sampling Date 12 �pZ- Sampling Time <br /> ' Sampimg Method Water Level Before Sampling(in feet BTOC) <br /> R1$ailer Type z`f t _ ❑ Same as Above <br /> ' ❑ Submersible ❑ Whale Grab Type <br /> ❑ Other ❑ Other Type i <br /> Sampling Distribution Sample Series <br /> ' Sample No Containers,Vol ,# Analysis_1 Preservative Lab Comments <br /> -z I � Yo! I <br /> I <br /> I <br /> ' Other Notes <br />