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BLAES Environmental Nriagement,lnc, GROUNDWATER SAMPLING FORM <br /> I433 North Third Aveaue <br /> Phoenix,Arizona 85003 Well No �- <br /> 602 728-0707 <br /> Well Type 1;3L Monitor ❑ Remedial VE AS <br /> Site ID fz <br /> ❑ Other <br /> Project No Jt L — 7o i T6 — c 3 Well Material �i PVC ❑ St Steel <br /> Recorded By M 0C' ❑ Other <br /> ' --Y- WELL PURGING <br /> Purge Volume Purge Date 12 3,6 L Purge Method <br /> Casing Diameter(D) in Inches ❑ Bailer Type <br /> ' ❑ 2 Inch A 4 Inch ❑ 6 Inch ❑ Other Submersible ❑ Submersible Whale <br /> Total Depth of Casing JD in feet dr� 7-0 _ 9Other <br /> Water Level Depth(WL In feet BTOC) Sy f r( Pump Intake Setting <br /> ' Number of Well Volumes(#Vols)to be <br /> 1.3 ❑ 4 ❑ 5 ❑ Other jELNear Bottom ❑ Near Top ❑ Other <br /> Depth in feet(BTOC) 8 <br /> Purge Volume Caiulation Screen Interval in Feet(BTOC) tC J <br /> !jrt, (y � to <br /> X gallons <br /> r X X 0 0409 = � . <br /> ` TD(feet) WL D(Inches) #Vols Calculated Purge Volume <br /> ' `Pump Time Purge Rate I Actual Purge Volume <br /> Start ALU Stop 1632- Time �7 '" Initial I gpm gallons <br /> Field Parameter Measurements Final Z gpm <br /> I �Gallons---Gond 1 �µ Cond 2 - <br /> Time Time Lapsed purged (umhos/cm) (umhos/cm) I Salm,ty Temp Notes <br /> I <br /> I <br /> i <br /> Observations During Purging(well Condition, Turbidity, Color, Odor, - - �+.,/) wt I�� q-W" <br /> Purge Water Storage/Disposal ❑Drum(s), Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> t Other/Comments J i C" <br /> _ WELL SAMPLING <br /> �p y p(r Sam fin Date- - 0 2 Sampling Time <br /> Sam led B 0� p g �2--q- - <br /> ' Sampling Method Water Level Before Sampiing(in feet BTOC) `f`I-Z.o <br /> 9 i <br /> S Bailer Type !�`� ❑ Same as Above <br /> ' ❑ Submersible ❑ Whale R Grab Type <br /> ❑ Other ❑ Other Type <br /> Sampling Distribution Sample Series <br /> ' Sample No Containers,Vol ,# Analysis Preservative Lab Comments <br /> m ;z c, i9m her $6tS D <br /> Duct 06, { I <br /> i <br /> Other Notes <br /> 1 <br />