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BLAES Environmental Management,Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> Phoenix,Arizona 85003 Well No MW-4C <br /> 602-728-0707 <br /> Well Type ■ Monitor ❑ Remedial -VE AS <br /> Site ID EJ-Haul #709-50 ❑ Other <br /> Prosect No 002-70950-04 Well Material ■ PVC ❑ St Steel <br /> Recorded By Greg Coffin _ ❑ Other <br /> WELL PURGING <br /> Purge Volume Purge pate / �2j Purge Method <br /> Casing Diameter(D)m inches ❑ Bailer-Type f"Yf.(►�lC "�`a <br /> 0 2-inch ❑ 4-inch ❑ 6-inch ❑ Other <br /> Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) -ft— ❑ Other <br /> Water Level Depth(WL in feet BTOC) 5-t, -7 7– pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> ❑ <br /> 3 El 4 [1 5 El Other Near Bottom [D Near Top [:1 Other <br /> Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 68 <br /> ,?-5-1_� _ to gg <br /> l z <br /> �& X 2 X 3 X 0 0409 = /` !3 gallons <br /> TD(feat) WL(feet) D(inches) #Vols <br /> Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start / r/ Tr Stop Time Elapsed Initial gpm gallons <br /> Field Parameter Measurements Final gprn <br /> Time Gallons Purged DO% DO(mg/L) (uCond m Cond 2 Salinity Temp pH Notes <br /> (umbos/cm) <br /> n <br /> rst , t5� S o ;v 7117 7fr 0 ,1 Zr � <br /> I 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/Comments Purge water contained in on-site 1,000 gallon poly tank pending analysisldisposal <br /> WELL SAMPLING <br /> IlSampe _Byld _U-IL4 Sampling Date U -/ Jo p3 ISampling !i=me �v <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 Serres --- _ -- — <br /> Sample No _ Containers,Vol ,# Analysis Preservative Lab Comments <br /> r <br /> Other Notes — <br />