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{ BLAES Environmental Management,Inc GROUNDWATER SAMPLING FORM <br /> 1 1433 North Third Avenue <br />!l Phoenix,Arizona 85003 Well No MW-6C <br /> 602-728-0707 <br /> Well Type ■ Monitor ❑ Remedial -VE AS <br /> 1 �Slte ID U-Haul #709-50 ❑ Other <br /> Project No 002-70950-04 Well Materlal ■ PVC ❑ <br /> St Steel <br /> Recorded By Greg Coffin ❑ Other <br /> WELL PURGING <br /> Purge VolumePurge DatePurge Method <br /> Casing Diameter(D)in inches El Bailer-Type <br /> 2-inch ❑ 4-inch ❑ 5-inch ❑ Other <br /> ❑ Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) AJ&7- ,— -7 (t ❑ Other <br /> Water Level Depth(WL in feet STOC) Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> ❑ Near Bottom ❑ Near Top El Other <br /> 03 ❑ 4 ❑ 5 [] Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 70 <br /> 1,t l 2 to 90 <br /> TDO(feet) X X 3 X 00409 = _ i�(/�/ - gallons <br /> WL(feet) 2 fD(inches) #Vols — <br /> Calculated Purge Volume <br /> Pump Time I JPurge Rate Actual Purge Volume <br /> i Start i 3 yy Stop r 3 5'1 Time Elapsed Initial gpm /y r gallons <br /> IField Parameter Measurements Final gpm <br /> Time Gallons Purged DO% DOm 1L Cond 1 Cond 2 <br /> ( g } Salinity Temp PB Notes <br /> (umhoslcm) (umhoslcm) <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 Sampling Date iZ fry o& Sampling Time 1p./rj <br />! Sampling Method Water Level Before Sampling(in feet BTOC) <br /> l,s <br /> Bailer-Type 3 ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> Sampling Distribution Sample Series --� <br /> Sample No i Containers,Vol,# I Analysis i Preservative P I Lab Comments <br /> i <br /> - i <br /> Other Notes - ' <br />