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i <br /> BLAES EnvrronmentalManagernent,Inc GROUNDWATER SAMPLING FORM <br />' 1433 North Third Avenue <br /> Phoenix,Arizona 85003 Well No MW-11C <br /> 602-728-4707 <br /> Well Type ■ Monitor ❑ Remedial -VE AS <br /> Iite ID U-Hauf #709-90 ❑ Other <br /> Project No 002-70950-04 Well Material ■ PVC ❑ St Steel <br /> Recorded By Greg Coffin ❑ Other <br /> II WELL PURGING <br /> Purge Volume Purge Date Purge Method <br /> I Casing Diameter(D)in inches ❑ Bailer-Type <br /> ■ 2-Inch ❑ 4-inch ❑ 6-inch ❑ Other ❑ Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD In feet BTOC) _ ElOther <br /> Water Level Depth(WL in feet BTOC) pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> ❑ <br /> 3 [:3 4 C] 5 1:1 Other Near Bottom [I Near Top El Other <br /> Depth in feet(BTOC) <br /> IPurge Volume Calulatlon Screen Interval in Feet(BTOC) from 65 <br /> s"' 1 z to $5 <br /> WL(feg <br /> — � ) X 2 X 3 X 0 0409 aflons <br /> TO(feet) (feet) D(inches) vols Calculated Purge Volume <br /> Pump Time jPurge Rate Actual Purge Volume <br /> Start ,T Stop 3 !,�- Time Elapsed Initial gpm 1 } gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons Purged DO% DO(mg/L) (uCond m) (umhosCond m) Salinity Temp pH Notes <br /> r><T, p 7 <br /> 7 b L 37( L) <br /> 3w `, 3a L `3's I ( � I ' >7>/3 v 7 r a <br /> LS f i+ <br /> Observations During Purging(well Condition Turbidity, Color Odor,etc <br /> I Purge Water Storage/Disposal ❑ Drum(s),Number [:] Storm Sewer E] Sanitary Sewer <br /> on <br /> Other/Comments Purge water contained in -site 1,000 gallon poly tank pending analysis/disposal <br /> WELL SAMPLING <br /> Sampled By i:; , Sampling Date 1 {71tV/147 ISampling Time <br /> Sampling Method I Water Level Before Sampling(in feet BTOC) <br /> ®-Bailer-Type L •s S �► ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> Sample No Containers Vol ,# I Analysis Presetive Lab <br /> rvaComments <br /> $z <br /> Other Notes <br />