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BLAES Environmental Management,Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> Phoenix,Arizona 85003 Well No MW-1013 <br /> M11111110,602-728-0707 <br /> Well Type ■ Monitor ❑ Remedial -VE AS <br /> Ite 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 Purge Method <br /> Casing Diameter(p)in inches � Bailer-Type /.5- <br /> N 2-inch ❑ 4-inch ❑ 6-rich ❑ Other ❑ Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) 6e S- - 7(, ❑ Other <br /> Water Level Depth(WL in feet BTOC) Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> ❑ Near Bottom ❑ Near Top ❑ Other <br /> ■ 3 ❑ 4 ❑ 5 ❑ Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 40 <br /> r s`_- _ l 2 to 60 <br /> l J X 2 X 3 X 0 0409 = / gallons <br /> \\\ TD(feet) WL{feet) D{inches) #Vols Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start 2 Stop cf j�Time Elapsed Initialm <br /> gA gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons Purged DO% DO(mg/L) (umhoslcm) (uCond m) Salmily Tomp pH Notes <br /> f <br /> 1 'S <br /> `J 35 T /t L <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!Comments Purge water contained in on-site 1,000 gallon poly tank pending analysis/disposal <br /> WELL SAMPLING <br /> Sampled By 0 ISampling Date /zlCr-'ice Sampling Time �: �/ <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 ISample Series — —� <br /> Sample No — Containers,Vol-# _ _ Analysis _ _Preservative Lab I Comments <br /> Other Notes <br />