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1 <br /> BLAS$ Emironmental Management Inc GROUNDWATER SAMPLING FORM <br /> 1413 Narth Third AN enue <br /> Phoenix Arizona 85003 Well No MW-513 <br /> 602 728 0707 <br /> WeH Type ■ Monitor 1:1 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 — �Gl`i 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 72 ❑ Other <br /> Water Level Depth(WL in feet BTOC) -.5b it Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be El Near Bottom ❑ Near Top ElOther <br /> M 3 ❑ 4 ❑ 5 ❑ Other Depth In feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 52 <br /> 2 to 72 <br /> 72 — X 2 X 3 X 0 0409 �Q t° gallons <br /> TD(feet) WL D(inches} a Vols Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start fGy Stop Time Elapsed Initial gpm M Z— gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons DO% DO(m /L) Cond 1 Gond 2 Salinity Temp NotesPurged <br /> (umhas/cm) (umhos/cm) <br /> rte r r> � � V O, l�f� ��{� �✓{ d � 'Z(.G <br /> q � (f rl o `t 2-7—G <br /> Observations During Purging(well Condition Turbidity Color Odor etc i u� L �Jzy <br /> i� <br /> I Purge Water Storage/Disposal ❑ Druni Number <br /> ❑ Storm Sewer El 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— — C) 3 Sampling Time jS 1�- <br /> Sampling Method Water Level Before Sampling(in feet BTOC) S 0 u <br /> 3( Gig} 4�1r� 1nei <br /> Bailer Type ,❑/Same as Above <br /> [:1CF Submersible ❑ Whale Grab Type <br /> ❑ Other ❑ Other Type <br /> Sampling Distribution Sample Series <br /> Sample No Containers Vol # Analysis Preservative Lab Comments <br /> rIS I] <br /> Other Notes <br />