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BLAES Envnronmentnlrbnagement,Ine GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue — I f �—�._... <br /> Phoenix,Aruon� lasaa3 Well No : 4 c <br /> ' 602 728x0707 <br /> • Well Type Xmonitor Cl Remedial VE AS <br /> Site ID <br /> ❑ Other <br /> ' Project No 6,;7, Well Material PVC ❑ St Steel <br /> Recorded By '"t f G © Other <br /> I - -- WELL PURGING <br /> Purge Volume Purge Date it-T— o[, Purge Method <br /> Casing Diameter(D) in inches ❑ Bailer Type <br /> ' [?�2 Inch ❑ 4 inch ❑ 6 inch ❑ Other Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet 8 5, ID 1J ❑ Other <br /> Water Level Depth(WL in feet BTOC) y{v i G _ pump Intake Setting^ <br /> ' Number of Well Volumes(#Vols)to be Near Bottom [INear Top ❑ Other <br /> 93 ❑ 4 115 ❑ Other Depth in feet(BTOC) <br /> ' Purge Volume Calulation Screen Interval in Feet(BTOC) <br /> - 5 x_— x 3 x 0 0409 = I 't `T 7 to <br /> gallons <br /> TI)(feet) WL D(inches) #Vols <br /> ll Calculated Purge Volume <br /> Pump Time IPurge Rate JActual Purge Volume <br /> Start 02& Stop f 5 Time '" N Initial ^ gpm <br /> gallons <br /> ' Field Parameter Measurements I Final '� 2 gpm <br /> Time <br /> Gallons Cord I Cond 2 <br /> Time Lapsed TI <br /> T <br /> Purged (umhas/cm) (umbos/cm) Salinity emp Notes <br /> i I <br /> I I I <br /> Observations During Purging(well Condition, Turbidity, Color, Odor, ✓ C,�{k✓ <br /> 'Vel r <br /> Purge Water Storage/Disposal ❑Drum(s), Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> ' Other/Comments _ et d-H ('DA <br /> WELL SAMPLING <br /> Sampled By. � [Sampling Date. I Sampling Ttme <br /> ' Sampling Method Water Level Before Sampling(In feet BTOC) W <br /> Bailer Type Z ( ❑ Same as Above <br /> ' ❑ Submersible ❑ Whale gGrab Type <br /> ❑ Other ❑ Other Type <br /> Sampling Distribution Sample Series <br /> ' Sample No Containers, Vol ,# Analysis Preservative Lab Comments <br /> Z-J64 <br /> � f ' <br /> Other Notes I <br /> 1 <br />