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I <br /> BLAES Environmental Management,Inc GROUNDWATER SAMPLING FORM <br /> E 1433 North Third Avenue <br /> Phoenix,Arizona 85003 Weli No MW-213 <br /> 602-728-0707 <br /> Weil Type ■ Monitor El Remedial -VE AS <br /> Site 1D __U-Haul#709-50 ❑ Other <br /> Project No 002-70950-04 Well Material ■ PVC ❑ St Steel <br /> Recorded By Greet Coffin ❑ Other <br /> IWELL PURGING <br /> Purge VolumePurge Date L 3 Purge Method <br /> Casing Diameter(D)in inches Z Bailer-Type <br /> 0 2-inch ❑ 4-inch ❑ 6-inch ❑ Other <br /> ❑ Submersible E] Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) -5 x `3Z ❑ Other <br /> Water Level Depth(WL in feet BTOC) 5 �b-�- Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> ❑ <br /> 3 ❑ 4 ❑ 5 ❑ Other Near Bottom El Near Top El Other <br /> Depth in feet(BTOC) <br /> Purge Volume Calulalion Screen Interval in Feet(BTOC) from 52 <br /> -7s -37- 2 to 77 <br /> r � — S7. `�Z1 2 <br /> l TD feet J X X 3 X 0 0409 = SS `� gallons <br /> ( ) WL(feet) D(inches) #Vols Calculated Purge Volume <br /> Pump Time Purge Rate JACtual Purge Volume <br /> Start 3SZ) Stop Wo Time Elapsed Initial gpm gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons Purged DO°/ 1 00(mg/L) Cond 1 Cond 2 Salindy Temp pH Notes <br /> (umhos/cm) (umhos/cm) <br /> 2- U tri Z 117-8 'Z--7 3 <br /> 2- <br /> 1 <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 Purge water contained in on-site 1 000 gallon poly tank pending analysis/disposal <br /> WELL SAMPLING <br /> Sampled By -(>L ISampling Date , U T, Sampling Time t i tr� <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> ❑ Bailer-Type ❑ 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 /> Other Notes <br />