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BLAE$ Managernent,Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> Phoenix,Arizona 85603 Well No MW-613 <br /> 602-728-0707 <br /> Well Type ■ Monitor ❑ Remedial-VE AS <br /> Site ID U-Haul#709-50 ❑ Other <br /> Project No 002-70950-04 Well Material ■ PVC ❑ St Steel <br /> Recorded By Greg Coffin ❑ Other <br /> WELL PURGING <br /> Purge Volume Purge Date I Z �r Purge Method <br /> -- S <br /> Casing Diameter(Q)in inches 0 Bailer-Type el`r /� <br /> ■ 2-inch ❑ 4-inch ❑ 6-inch ❑ Other <br /> ❑ Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) -"i"R ❑ Other <br /> Water Level Depth(WL in feet BTOC) 7 n'7— Pump Intake Setting <br /> Number of well Volumes(#Vols)to be Purged ❑ Near Bottom <br /> ❑ Near Top ❑ Other <br /> 0 3 ❑ 4 ❑ 5 ❑ Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(STOC) from 52 <br /> A <br /> 1X_ Ct <br /> 2 to 72 <br /> CT ( et) (feet) D X 2(inches) #Vols X 3 X 0 0409 = _ 0,raj gallons <br /> Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start / y/ Stop Time Elapsed Initial gpm - 7 S__gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons Purged DOS, DO(mglL) Cond 1 Cond 2 Sahrnty Temp pH Notes <br /> (umhos/cm) (umhos/cm) <br /> lit)L <br /> - --- -� _- - - 1-- --- - -- --- - ------ -_ ---- �- ----- -- _ f- - - _ 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 analysis/disposal <br /> L. WELL SAMPLING <br /> Sampled By y/'.j ISampling Date 1�- to e,3Sampling Time Id jrp <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 j Containers,Vol,# Analysis Preservative I Lab Comments <br /> ' i- <br /> I I <br /> I <br /> Other Notes <br />