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BLAES Environmental Management,Inc GROUNDWATER SAMPLING FORM <br /> ' 1433 North Third Avenue <br /> Phoenix,Arizona 95003 Well No MW-12C <br /> 02-728-0707 <br /> Well Type ■ Monitor ❑ Remedial-VE AS <br /> ' Ite ID U-Haul #709-50 ❑ Other <br /> Project No 002-70950-04 Well Material ■ PVC ❑ St Steel <br /> Recorded By ❑ Other <br /> ' I WELL PURGING <br /> Purge Volume JPurge Date I la 10� Purge Method <br /> Casing Diameter(D)in inches Atsuirer'-Type '461"�� <br /> ■ 2-inch ❑ 4-inch [❑ 6-inch ❑ Other ,Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) 85 ❑ Other <br /> ' Water Level Depth(WL in feet BTOC) - Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged lafi <br /> ❑ <br /> 3 El 4 ❑ 5 1:1 Other -Near Bottom ❑ Near lap Other <br /> Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 65 <br /> 85 — 2 to 85 <br /> ��`�� X 2 X 3 X 0 0409 = 1 Sr gallons <br /> ' TD(Leet) WL(feet) l D(inches) #Vols Calculated Purge Volume <br /> Pump Time I Purge Rate I 14-c—tual Purge Volume <br /> Start T O Y- Stop Time Elapsed Initial gpm is gallons <br /> Field Parameter Measurements Final gpm <br /> ' Time Gallons Purged DO% DO(mglL) Cord 1 Cond 2 Salinity Temp Notes <br /> (umhoslcm) (umhoslcm) <br /> i,pg LT-7 (11;-,z 0.3 Zv 7 <br /> -r 665- 03 Co <br /> t-7 t� Is z ;-3� 6C0 b" o 7-91, <br /> 17- 5­6 i/ 6Y8 0-3 =n <br /> ' Observations During Purging(well Condition,Turbidity,Color,Odor,etc [ r''_' , <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 tank pending analysis/disposal <br /> WELL SAMPLING <br /> Sampled By [_LCSampling Date (� / Sampling Time I b±3p <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> ' Bailer-Type 3' DIS usable ❑ Same as Above <br /> Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> ' Sampling Distribution Sample Series <br /> Sample No Containers,Val,# Analysis Preservative Lab Comments - <br /> (1) 1 L Amber 8015 None Diesel <br /> MW-12C (3)40mL Voa's 8260 HCI Seq Gasoline, BTEX, Fuel <br /> Oxy's, 1,1-DCA, 1,2-DCA <br /> Other Notes <br />