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I <br /> I BLAES Environmental Management,Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> Phoenix,Arizona 85003 Well No MW 12C <br /> 602-728-0707 <br /> Well Type ■ Monitor 11 Remedial-VE AS <br /> ISite 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 _) L9/0Purge Method <br /> I Casing Diameter(D)in Inches <br /> 2-Inch <br /> ❑ 4-Inch ❑ 8-Inch ❑ Other Bailer-Type <br /> ❑ Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) 4* �iv 3-' ❑ Other <br /> I Water Level Depth(WL In feet BTOC) Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> � 3 [:] 4 E] 5 1:1 Other El Near Bottom El Near Top El Other <br /> I Depth in feet(BTOC) <br /> Purge Volume Caluiation Screen Interval In Feet(STOC) from 65 <br /> -1.02 2 to 85` <br /> 8b <br /> TD(feet) wLr(feet) X n(inches) X #Vols X 0 0409 gallons <br /> I Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start Stop Time Elapsed Initial gpm gallons <br /> Field Parameter Measurements Final gpm <br /> I Time Gallons Purged DO% DO(mglL) Cond 1 Cond 2 <br /> (umhoslcm) (umhoslcm) Salinity Temp pH Notes <br /> y c 5y c, z7 a L, ► 71 C) V22- 6-it 19, L <br /> 4� f z LFA s' _Z,(aS 7 z-2 <br /> Observations During Purging(well Condition,Turbidity,Calor,Odor,etc <br /> I Purge Water Storage/Disposal [] Drum(s) Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> Other 1 Comments Purge water contained In on-site 1,000 gallon poly tank pending analysis/disposal <br /> WELL SAMPLING <br /> Sampled By I ISampling Date Mho/03 —Sampling Time q-c)o <br /> Sampling Method Water Level Before Sampling (in feet BTOC) <br /> I Bailer-Type ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> I Sampling Distnbution Sample Senes <br /> i Sample No Containers,Vol,# Analysis Preservative Lab l Comments <br /> I I <br /> � I <br /> IOther Notes <br />