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' BPF4 5 Environmental Management,Inc- <br /> GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> ' Phoenne,Anzoaa sSpfl3 Well No.- <br /> Site ID q 6 <br /> 11 - <br /> 2 728-0707 <br /> Well Type 1a-Monitor ❑ Remedial VE AS <br /> —( ,,�, <br /> ❑ Other <br /> ' Protect No —&t 2~- 7C j 0 - 03 Weil Material 2K PVC ❑ St Steel <br /> Recorded By _ (r _ ❑ Other <br /> WELL PURGING <br /> Purge Volume Purge—Date 12_ y _ C L -0-u-r <br /> ge Method ; <br /> Casing Diameter(D)in inches ❑ Bailer Type <br /> ' Q(2 inch ❑ 4 inch ❑ 6 Inch [] Other Submersible ❑ Submersible Whale <br /> Total Depth of Casmg(TD in feet -71 L, ❑ Other <br /> Water Level Depth(WL in feet 8TOC) _ `S< �zo„ Pump Intake Setting <br /> ' Number of Well Volumes(#Vofs) to be ,�/ <br /> 3 ❑ ¢ ED S El Other P< El Bottom Near Top Other <br /> Depth In feet(BTOC) L <br /> ' <br /> Purge Volume Calulahon Screen interval In Feet(BTOC) i�7T <br /> 2 to l � <br /> Tp(teet) w� X X 3 X 0 0409 = 7 7G _ gallons <br /> ' D(Inches) u Vols Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start rCA'X Stop 1011, Time i" Initial ^ gpm 0 <br /> gallons <br /> ' Field Parameter Measurements Final ^ = gpm <br /> TimeLa Gallons Cond 1 Cond 2 <br /> Time sed — - <br /> -- - -- - -- P -- - -- - - - --__ --- I Purged {uSalinity I Temp I Notes_— — - - <br /> ---- - {umbos/cm) (umbos/Cm) <br /> i <br /> 1 I <br /> I <br /> I I <br /> I <br /> Observations During Purging(well Condition,Turbidity, Color, Odor, C 11"A K e <br /> Purge Water Storage/Disposal []Drum(s), Number <br /> ❑ Storm Sewer ❑ Sanitary Sewer <br /> ' Other/Comments 'D N5-k— 0-&t Ito-, -6-04— <br /> WELL SAM LING <br /> Sampled By MtGl Sampling Date. z-!5- —dZ Sampling Time <br /> ' Sampling Method Water Level Before Sampling(in feet BTOC) 7 1 T-0 <br /> tr <br /> aBaller Type 11 ❑ Same as Above <br /> ' ❑ Submersible ❑ Whale 7KGrab Type <br /> ❑ Other ❑ Other Type <br /> Sampling Distribution Sample Series <br /> ' Sample No I Containers, Vol ,# Analysis + Preservative Lab Comments ! <br /> ✓ Ap{ a✓ <br /> t <br /> ' Other Notes <br /> a <br />