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BLAS$ Env[ronme.,IManagement,Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> Phoenix,Arizona 85443 Well No MW-4C <br /> 642-728-0747 <br /> Well Type ■ Monitor 11 Remedial -VE AS <br /> ite ID U-Haul #709-50 0 Other <br /> Project No 002-70950-04 Well Material ■ PVC ❑ St Steel <br /> Recorded By Greg Coffin T� ❑ Other <br /> WELL PURGING <br /> Purge Volume Purge Date ,(z ky Purge Method <br /> Casing Diameter(D)in inches ❑ Bailer-Type <br /> ■ 2-inch ❑ 4-inch ❑ 6-inch [] OtherSubmersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) 7 1 ❑ Other <br /> Water Level Depth(WL in feet BTOC) 5-S S 7 Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged Near Bottom ❑ Near Top El Other <br /> 3 [_1 4 El 5 1-1 Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 68 <br /> _ to 88 <br /> z <br /> TD f t WL fee x 2 X 3 X 0 0409 = y $0 gallons <br /> ( ) (feet) D(inches) #Vols Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start //71 Stop It SV Time Elapsed r 9 Initial gpm /� gallons <br /> Final gpm <br /> Field Parameter Measurements <br /> Time Gallons Purged, DO% I DO(mg/L) Cond 1 Cond 2 Salinity Temp i Notes <br /> i <br /> (umhos/cm) (umhos/cm) - <br /> it 'r3 a C Y iS a �6 I fl ZS <br /> �r <br /> 'Y 7 t z 3 a �f r G j� �&7 ra Z t/ <br /> Observations During Purging(well Condition,Turbidity,Color,Odor,etc <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 i - <br /> Sampled By GC Isampling Date Sampling Time <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> E Bailer-Type 3' Disposable ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> Sample No Containers,Vol,# Analysis Preservative Lab Comments <br /> (1) 1 L Amber 8015 None Diesel <br /> MW-4C �(3)40mL Voa's 8015 HCI Seq Gasoline <br /> (3)40mL Voa's 8260 HCl BTEX, Fuel Oxy's, 1.1- <br /> DCA, 1,2-DCA <br /> Other Notes <br />