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BLAES Environmental Management,Inc GROUNDWATER SAMPLING FORM <br /> 4 1433 North Third Avenue <br /> Phoenix,Arizona 85003 Well No MWAC <br /> 602-728-0707 Well Type M Monitor ❑ Remedial-VE AS <br /> Site ID U-Haul#709-50 <br /> ❑ Other , <br /> $Protect No 002-70950-06 Well Material ■ PVC ❑ St Steel <br /> Recorded By © Other <br /> WELL PURGING ��1 i <br /> Il Purge Volume Purge Date �� Purge Method <br /> JCasing Diameter(D)In inches ❑ Bader-Type <br /> ® 2-Inch ❑ 4-inch ❑ 6-inch ❑ Other ® Submersible ❑ Submersible Whale <br /> Total Depth of Casing (TD In feet BTOC) 100 ❑ Other <br /> I, Water Level Depth(WL in feet BTOC) - 5"1 (X Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> 11 ® Near Bottom El Near Top [I Other <br /> ■ 3 [J 4 El 5 El Other <br /> �J ? <br /> Depth In feet(BTOC) --80 <br /> Purge Volume Calulatlon Screen Interval In Feet(BTOC) from 75 <br /> 2 to 100 <br /> TD(feet) <br /> t) wL(57'rteetb X o(2ches) X #Vols X 0 0409 = U-- gallons <br /> Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start S 11 Stop Time Elapsed Initial gpm gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons Purged' DO% DO(mg/L) (uCond m) (u Co s!m) Salinity Temp Noles <br /> (7s z'-L.. P fj V C-T< b <br /> t37a ( r- 7b � ba �3P � � zz- <br /> � <br /> Observations Dunng Purging(well Condition,Turbidity,Color,Odor,etc <br /> Purge Water Storage/Disposal ❑ Drum(s) Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> Other 1 Comments Purge water contained in on-site 1,000 gallon poly lank pending analysis/disposal <br /> WELL SAMPLING <br /> Sampled By GC Sampling Date 1 _-3 ISampling Time $ .3-r <br /> Sampling Method Water Level Before Sampling(in feet BTOC) N <br /> ' Bailer-Type 3' DIS osable ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> '! ❑ Other ❑ Other-Type <br /> fESampling Dlstribution Sample Series <br /> Sample No Containers,Vol,# Analysis Preservative Lab Comments <br /> ' (1) 1 L Amber 8015 Diesel <br /> MWA C (2)40mL Amber Voa's HCP ESC Gasoline <br /> x <br /> (2)40mL Amber VoBTEX, Fuel Oy's, 1,1- <br /> a's 8280 � � <br /> ----- — - -_ ---- - - ---- - - - - �- - - - - - - - -- --- <br /> DCA,-1,2-DCA- <br /> Other <br /> CA, 1,2-DCAOther Notes <br /> 11 <br /> I <br />