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' BLAES EnviromaentalManagement,Inc. GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue / <br /> ' Yhocaix,Aruona 85003 Well No., 7 <br /> bax 728-0707 <br /> Well Type �Monitor ❑ Remedial VE AS <br /> Site 10 lA— is ( fit `t ❑ Other <br /> ' <br /> Project No 6L) YTC) - o 3 Well Material , PVC 0 St Steel <br /> Recorded By M P( ❑ Other <br /> WELL PURGING --- -- - -- ---- - - - <br /> Purge Volume Purge Date Purge Method <br /> Casing Diameter(D) in inches lktailer Type <br /> ❑ 2 Inch J�(4 inch ❑ 6 inch [] Other ,[ ❑ Submersible ❑ Submersib;e Whale <br /> Total Depth of Casing(TD in feet 7 I ❑ Other <br /> Water Level Depth(WL In feet BTOC) Pump Intake Setting <br /> Number of Well Volumes(#Vols) to be <br /> ❑ Near Bottom ❑ Near Tap ❑ Other <br /> g3 ❑ 4 ❑ 5 ❑ Other Depth in feet(STOC) <br /> Purge Volume Calulatlon Screen Interval in feet(BTOC) 4*'� <br /> _ to <br /> 7D(feet) WL <br /> J X X x 0 0409 gallons <br /> 0(inches) #Vols Calculated Purge Volume <br /> Pump Time JPurge Rate Actual Purge Volume <br /> Start f Stop y Time Initial gpm 60 gallons <br /> ' Field Parameter Measurements _1 - Final - - -gpm <br /> -r <br /> Gallons Cond 1 Cand 2 <br /> Time Time Lapsed Salinity j Temp Notes <br /> Purged (umhos/cm) (umhos/cm) <br /> r <br /> r <br /> r _ <br /> Observations During Purging(well Condition,Turbidity,,Color, Odor, Jz Q -1 f 0 <br /> '4 <br /> Purge Water Storage/Disposal ❑Drum(s),Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> Other/Comments 0"`S r� 1 4 -- <br /> WELL SAMPLING <br /> Sampled B� (Nt f� Sampling Date _/Z-(,.,--O Z- ISamplingTime. <br /> ' Sampling Method Water Level Before Sampling(!n feet BTOC) 4 60 <br /> Rtaller Type ❑ Same as Above <br /> ' ❑ Submersible ❑ Whale `Grab Type <br /> ❑ Other ❑ Other Type <br /> Sampling Distribution Sample Series <br /> , <br /> ' Sample No Containers,vol,# Analysts Preservative Lab Comments I <br /> Other I ( 1P r I w,Q✓ <br /> i <br />