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BLAESEn,ironmentatManagement the GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> Phoenix Arizona 85003 Well No MW-3C <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 - e 3, Purge Method <br /> Casing Diameter(D) in inches ❑ Bailer Type <br /> E 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) �7' (- Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be [:1 Near Top [:1 Other <br /> [I Near Bottom <br /> ■ 3 ❑ 4 ❑ 5 ❑ Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen interval in Feet(BTOC) from 75 <br /> z to 100 <br /> 100 — t�� 2 X 3 X 0 0409 = i-'3-�'S gallons <br /> TD{feet) WL X D(inches) #vols Calculated Purge Volume <br /> r Pump Time _ Purge Rate Actual Purge Volume <br /> Start 1 s5"i Stop (,G"J Time Elapsed Initial 3' gpm Z� gallons <br /> Final n 'Z gpm <br /> Field Parameter Measurements <br /> Time Gallons Do% pp(mg/L) Cond 1 coed 2 Salinity Temp pH Notes <br /> Purged ° (umhos/cm) (umhos/cm) <br /> o.5-4 771 TC 4 21. .- <br /> f <br /> (,t(, z-.,, . �- _ I Z L. -76 Z 817 0 `f Z 14 <br /> Observations During Purging(well Condition Turbidity Color Odor etc ❑r <br /> r Purge Water Storage/Disposal ❑ Drum(s) Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> Other/ Comments Purge water contained in on site 1,000 gallon poly tank pending analysis/disposal <br /> - —-----T WELL SAMPLING <br /> Sampled By _ v - Sampling Date — -��(,-0 3 Sampling Time ' L` <br /> Sampling Metlhjo_ Water Leve <br /> Method / t Before Sampling(in feet BTOC) <br /> tib <br /> r Bailer Type 1 �11 1 c.fQt ❑ Same as Above <br /> 0 Submersible ❑ Whale Grab Type <br /> ❑ Other [:] Other Type <br /> Sampling Distribution _ Sample Series <br /> i Sample No Containers Vol # Analysis Preservative Lab Comments <br /> 3totr-i- <br /> Other Notes <br />