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SLAES EnvlronmentalManagement,Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Tblyd Avenue <br /> Pbeenlx,Arizona 85003 Well No MW-12B <br /> 602-728-0707 <br /> Well Type ■ Monitor ❑ Remedial-VF AS <br /> 0ite ID U-Haul #709-50 13 Other <br /> Project No 002-70950-04 <br /> Well Material ■ PVC ❑ St Steel <br /> Recorded By Greg Coffin <br /> ❑ Other <br /> WELL PURGING <br /> Purge Volume Purge Date sfz��o Purge Method <br /> Casing Diameter(D)in inches N Bailer-Type 6' PVC <br /> I N 2-inch ❑ 4-inch ❑ 6-inch ❑ Other ❑ Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) ❑ Other <br /> Water Level Depth(WL in feet BTOC) Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> ❑ Near Bottom El Near Top E:1 Other <br /> ■ 3 [:14 ❑ 5 ❑ Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 40 <br /> r _ l 2 2 3 to 60 <br /> TDD(feet) s4 �� J X X X 0 0409 = 1 9 l� gallons <br /> l WL(feel) D(inches) #Vols <br /> Calculated Purge Volume <br /> Pump Time Purge Rate JActual Purge Volume <br /> Start G Z7 Stop __6 Time Elapsed t V Initial gpm gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons Purged' DO% DO(mg1L) I (uCond m) I {umbos!m) i Salinity Temp Notes <br /> Z r tJ � i `T � I O Gc 7f <br /> 3Z r 9 c' mss` <br /> 717 <br /> ry �y i 5 t2 _, i7 ':—e-31.) �zg r i r47- 3 <br /> I - <br /> Observations During 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 tank pending analysis/disposal - <br /> WELL SAMPLING <br /> Sampled By GC Sampling Date `;� /d Sampling Tlme 7vg <br /> Sampling Method Water Level Before Sampling(in feet BTOC) a� <br /> Bailer-Type 3' Disposable ❑ Same as Above <br /> t ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> Sampling Dilstribution Sample Series <br /> Sample No Containers Val,# R Analysis Preservative Lab I - -- Comments <br /> (1) 1 L Amber 8015 None Diesel <br /> MW-12B (3)40mL Voa's I 8015 I HCI Gasoline <br /> f Sep(3)40mL Voa's 8260 HCI ��TEX, Fuel Oxy's, <br /> _ ___ DCA, 1,2-DCA <br /> Other Notes <br /> I <br />