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BLAES Environmental Management,Inc GROUNDWATER SAMPLING FORM <br /> I 1433 North Third Avenue <br /> Phoenix,Arizona 85403 Well NO MW-10C <br /> 602-728-0707 <br /> Well Type ■ Monitor Cl Remedial -VB AS <br /> E Stte ID U-Haul #709-50 <br /> Project No 002-70950-44 1:1 Other <br /> Material ■ PVC ❑ St Steel <br /> Recorded By Greg Coffin <br /> E , ,-- ❑ Other <br /> WELL PURGING <br /> Purge Volume Purge Date �F~- `j C Purge Method <br /> Casing Diameter(D)in inches <br /> Z Bailer-Type <br /> 2-inch <br /> ❑ 4-inch p 6-inch [] Other <br /> ❑ Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) 84--S-gr- t l ❑ Other <br /> Water Level Depth(WL in feet BTOC) 5s pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> ❑ Near Bottom Ll Near Top El Other <br /> 0 3 [:14 ❑ 5 ❑ Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 64 5 <br /> /& 2 to 84 5 <br /> X 2 X 3 X 0 0409 = l > gallons <br /> TD(feet) WL(feet) J D(inches) #Vols Calculated Purge Volume <br /> Pump Time I JPurge Rate Actual Purge Volume <br /> Start Stop Time Elapsed Initial gpm I V gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons Purged 00% DO(mglL) (uCond m) (uCond m) salinity Temp pH Notes <br /> el cS C, y- <br /> `j �+ `� r u 2— t G 5'� 7LL1' - `f • '7 <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 Date ISampling Time $.Z Z <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 /> I <br /> Sampling Distribution Sample Series <br /> Sample No No — Containers Vol # Analysis Preservative I Lab Comments <br /> Other Notes <br />