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BLAES EnvironmentalMansgement,Inc GROUNDWATERSAMPLING FORM <br /> ' 1433 North Third Avenue <br /> 4 <br /> Phoenix,Arizona 85003 Well No MW-11 C <br /> OZ-728-0787 <br /> Well Type ■ Monitor ❑ Remedial-VE AS <br /> Site ID U-Haul #709-50 ❑ Other <br /> Project No 002-70950-06 Well Material ■ PVC ❑ St Steel <br /> Recorded By <7k J ❑ Other <br /> WELL PURGING <br /> Purge Volume Purge Date y� Purge Method <br /> Casing Diameter(D)in inches ❑ Bader-Type <br /> 0 2-inch ❑ 4-inch ❑ 6-inch ❑ Other Submersible ❑ Submersible Whale <br /> Total Depth of Casing JD in feet BTOC) 85 ❑ Other <br /> ' Water Level Depth(WL in feet BTOC) <�-7 7`1 Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> Near Bottom El Near Top [I Other <br /> N 3 ❑ 4 [:15 ❑ Other Depth in feet(BTOC) --80 <br /> ' Purge Volume Calulation Screen Interval in Feet(BTOC) from 65 <br /> 2 <br /> to 85 <br /> 7D�eet W creat X 2 X 3 X 0 0409 = ( � gallons <br /> ' (feet) ) D(inches) #Vols Calculated Purge Volume <br /> Pump Time JPurge Rate Actual Purge Volume <br /> Start IZ'YC Stop 1,3 1 z-- Time Elapsed &I'm Initial gPm IT z-' gallons <br /> Final gpm <br /> Field Parameter Measurements <br /> Time i Gallons Purged DO% DO(mg/L) (uCond m) (u Cond s!m) Salinity Temp Notes <br /> 13 el 2q z Y2 Nl� ,v,4 A(-f 2 z n <br /> 13 of 8 Z-7,L 2- q z <br /> 13,17 r3 Z-�.3 2.3-A L1, 6 <br /> ' Observations During Purging(well Condition,Turbidity,Color,Odor,etc <br /> ' Purge Water Storage/Disposal ❑ Drum(s),Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> Other/Comments <br /> WELL SAMPLING <br /> ' Sampled By O Sampling Date {3a/0� Sampling Time 83S T <br /> Sampling Method Water Level Before Sampling(in feet BTOC) 114A <br /> ' Bailer-Type 3' Disposable __ ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> ' Sampling Distribution- - sample series <br /> T-0ther <br /> Sample No Containers,Vol ,# Analysis Preservative I Lab Comm_ents <br /> (1) 1 L Amber i �- Diesel(2- )4OmL Amber Voa's, 8015 ESCGasolineMW-11C BTEX, Fuel Oxy's, 1,1- <br /> 1 (2)40ML Arnber Voa's I 8260DCA, 1,2-DCA <br /> Notes <br />