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i <br /> $LASS EnVironmentalManagement,In(- GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> Phoenix Arizona 85003 Well No MW-1c <br /> 602 728 0707 <br /> Well Type ■ Monitor ❑ Remedial VE AS <br /> Site ID U Haul #709 50 ❑ Other <br /> r Project No _ 002 70950 04. Well Material ■ PVC ❑ St Steel <br /> Recorded By Greg Coffin ❑ Other <br /> WELL PURGING <br /> Purge Volume Purge Date .57b/i: Purge Method <br /> 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 in feet 100 ❑ Other <br /> Water Level Depth (WL in feet BTOC) Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be <br /> EJ Near Near To Near Bottom p El Other <br /> 0 3 ❑ 4 ❑ 5 ❑ Other Depth in feet (BTOC) <br /> Purge Volume Calulaticn Screen Interval in Feet(BTOC) from 75 <br /> 2 to 100 <br /> 100 t� — 577 7� 2 X 3 X 0 0409 = 4-- Y i 7 gallons <br /> TD(fe { WL X D(inches) #Vols Calculated Purge Volume <br /> r Pump Time Purge Rate Actual Purge Volume <br /> Start // M Stop ,Z'I Time Elapsed Initial gprri 1zC-,-- gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons DO% D0(mg/L) Cond 1 Cond 2 Salinity Temp pH Notes <br /> 0 Purged (umhos/cm) (umhos/cm) <br /> 1 /,' (cv I p —,56 7i1( —7-17 O Ll Z(Y <br /> �d_0 - - v IM 7 t% -7-73 4 1( ; — <br /> r2'Of 11c;_ _ a `� -7z,5-_ -1�S n 2r -� <br /> 1 7_`X7 za ro - 73 c7 7T 1 C7 4 Z t ? <br /> f Z'uSc V� y r e7.3 S `7 YZ> `78' <br /> Observations During Purging(well Condition Turbidity Color Odor etc <br /> Purge Water Storage/Disposal ❑ Drum(s), Number- E] 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 Sampling Date 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 />