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1 <br /> BLAES Environmental Management,Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> Phoenix,Arizona 85003 Well No MW'16 <br /> • 602 728-0707 <br /> Well Type ■ Monitor ❑ Remedial VE AS <br /> Site ID U Haul #709 50 ❑ Other <br /> Prolect No 002 70950 04 Well Material ■ PVC © St Steel <br /> Recorded By Greg Coffin _ ❑ Other <br /> WELL PURGING <br /> Purge Volume Purge Date e::7-1 /17r Purge Method <br />(1 Casing Diameter(D)in inches ❑ Bailer Type <br /> 0 2 inch [] 4 inch ❑ 6 inch ❑ Other ❑ Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD ir feet 77 ❑ Other <br /> Water Level Depth(WL in feet BTOC) Pump Intake Setting <br /> Number of Well Volumes(# Vols)to be <br /> ❑ Near Bottom El Near Top El Other <br /> 1 0 3 ❑ 4 ❑ 5 ❑ Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 52 <br /> 2 to 77 <br /> 77 �7 2 X 3 X 0 0409 = 1�, C? gallons <br /> Td{feet} WL X D(inches) #Vols <br /> Calculated Purge Volume <br />' Pump Time Purge Rate Actual Purge Volume <br /> Start ICZZ Stop 1/50 Time Elapsed Initial gpm s$zW 1Z r gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons `DC% DO(mg/L) Cond 1 Cord 2 Salcmty Temp pH Notes <br /> Purged (umhos/cm) (umhos/cm) <br /> '72- ��--wiz a Z( <br /> z <br /> Observations During Purging(well Condition Turbidity Color Odor etc �, .,tr,�� } ,+ vt,,- <br /> 7 <br /> Svc ..' [Z S "J6 [ 'V <br /> Purge Water Storage/Disposal ❑ Drum(s) Number— F-1StormSewer ❑ 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 f 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 Sample Series <br /> Sample No _Containers Vol # Analysis Preservative Lab Comments <br /> Other Notes <br />