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BLAES Enxtronmental Managtment Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third ANenue MW-3 B •-� � <br /> Phoenix,Arizana 85003 Well No <br /> • 602 728 0707 <br /> Well Type ■ Monitor ❑ Remedial VE AS <br /> Site 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 Purge Method <br /> Casing Diameter(D) in inches ❑ Bader Type <br /> 0 2 Inch ❑ 4 Inch ❑ 6 inch ❑ Other ❑ Submersible ❑ Submersible Whale <br /> Total Depth of Casing JD in feet 77 ❑ Other <br /> Water Level Depth (WL in feet BTOC) Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be <br /> El Near Near To Near Bottom p E] Other <br /> E 3 ❑ 4 ❑ 5 ❑ Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 52 <br /> 77 — z <br /> to 77 <br /> X <br /> 4f/ 2 X 3 X 0 0409 = gallons <br /> 1 TD(feet) WL D(inches) #Vols Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start Stop Time Elapsed Initial gprn gallons <br /> — Final gpm <br /> Field Parameter Measurements <br /> Gallons Cond 1 Cond 2 SalinityTemp pH Notes <br /> Time Purged DO% DO(mg1L) (umhas/cm) (umhos/cm) <br /> i � E <br /> Observations During Purging(well Condition Turbidity Color Odor etc <br /> Purge Water Storage/Disposal ❑ Druni Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> Other/ Comments Purge water contained sn 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 /> r ❑ 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 /> i <br />