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1 <br /> BLAES Envuonmentalbianagement Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> Phoenix Arizona 85003 Well No MW-413 <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 Weil Material ■ PVC ❑ St Steel <br /> Recorded By Greg Coffin ❑ Other <br /> WELL PURGING <br /> Purge Volume Purge Date wrr Purge Method <br /> Casing Diameter(D) in inches ❑ Bailer Type <br /> E 2 inch ❑ 4 irlCh [:16 inch ❑ Other ❑ Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet 70 ❑ Other <br /> Water Level Depth(WL in feet 3TOC) Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be ❑ Near Bottom ❑ Near Top ❑ Other <br /> r N 3 ❑ 4 ❑ 5 ❑ Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 45 <br /> to 70 <br /> z <br /> 70 — 57),t7"' 1 X 2 X 3 X 0 0409 = '7 gallons <br /> TD(feet) WL J D(inches) #Vols Calculated Purge Volume <br /> r Pump Time Purge Rate Actual Purge Volume <br /> Start / _SS--Stop Vivi Time Elapsed initial gpm gailons <br /> - Final gpm <br /> Field Parameter Measurements <br /> lime Gallons DO% DO(mg/L) Cond 1 Cond 2 Salinity Temp pfd Notes <br /> Purged (umhos/cm) (umhos/cm) <br /> <7 Z-S 5 r 0_ttz- <87 -I %gt 1- 0 v -Z <br /> '�-s �5- o n-'9 9-i -7 <br /> 0 bZ' -1Y3 L -4- L- 4 V 2� <br /> i <br /> Observations During Purging(well Condition Turbidity Color, Odor, etc <br /> ��,F <br /> 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 /> WELL SAMPLING <br /> Sampled By Sampling Date J Sampling Time <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br />• ❑ Bailer Type ❑ Same as Above <br /> ❑ Submersibte ❑ Whale ❑ Grab Type <br /> ❑ Other ❑ Other Type <br /> Sampling Distribution Sample Series <br /> Sample No W Containers Vol # Analysis Preservative Lab Comments <br /> Other Notes <br />