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1 <br /> BLAES Envoronmentnl Management,Ine GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> Phoenix,Arizona 85003 Well NO MW-2C <br /> 02-728-0707 <br /> Well Type ■ Monitor ❑ Remedial -VE AS— <br /> S <br /> ite <br /> SSlte ID U-Haul #709-50 ❑ Other <br /> Project No 002-70950-04 Well Material ■ PVC ❑ St Steel <br /> Recorded By ❑ Other <br /> ' WELL PURGING <br /> Purge Volume [urge Date IPurge Method <br /> Casing Diameter(D)in inches ❑ Bailer-Type <br /> 0 2-inch ❑ 4-inch ❑ 6-inch ❑ Other E Submersible ❑ Submersible Whale <br /> Total Depth of Casing(To in feet BTOC) 100 ❑ Other <br /> ' Water Level Depth(WL in feet BTOC) pump Intake Setting <br /> !Number of Well Volumes(#Vols)to be Purged <br /> Near Bottom [I Near Top ❑ Other <br /> ■ 3 ❑ 4 ❑ 5 ❑ Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 75 <br /> z to 100 <br /> (feet) <br /> — S3X 2 X 3 X 0 0409 = Z2, :-Z gallons <br /> TQ(feei) WL(feet)) D(inches) Vols Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start `il'vo Stop Time Elapsed Initial gpm 2 gallons <br /> Final gpm <br /> Field Parameter Measurements <br /> Time Gallons Purged DO% DO(mg/L) { Cond 1 ) (u mhos!m) <br /> 6 Salinity Temp Notes <br /> p J umhos/cm <br /> 1 f� o 6 0, Sy �_" T Zo ( l?[ez✓! STi<<t y C Ode! <br /> 7. 06 /0 97 G S G -- -- — t . 7- <br /> i q;ol 1 �-- z,q <br /> 1 <br /> ' Observations During Purging(well Condition,Turbidity,Color,Odor,etc �1 ej ry7C Cr <br /> ' Purge Water StoragelDisposal [] Drum(s), Number ❑ Storm sewer ❑ Sanitary Sewer <br /> Other!Comments Purge water contained in on-site 1,000 gallon poly tank pending analysis/disposal <br /> WELL SAMPLING <br /> ' Sampled By--I ijr kt� Sampling Date 3 b b-Z;- Isampling Time I [(; 23 <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> 0 Bailer-Type 3' Disposable ❑ Same as Above <br /> ❑ Submersible ❑ Whale Grab-Type <br /> ❑ Other ❑ Other-Type <br /> Sampling Distribution sample renes I <br /> Sample No Containers,Vol,# Analysis Preservative Lab Comments_ <br /> (1) 1L Amber 8015 _None_ _ _Diesel _ <br /> 7--other <br /> MW-2C {3)40mL Voa's8015 HCI - - Sea � Gasoline(3)40mL Voa's 8260 Full List fFuel Oxy's <br /> Notes <br />