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BLAES EmironMentalManagement,Inc GROUNDWATER SAMPLING FORM <br /> 1433 worth Third Avenue <br /> Phoenix Arizona 85003 Well No MW-141C <br /> . 601 728 0707 <br /> Well Type ■ Monitor ❑ Remedial VE AS <br /> Site ID U Haul #709 50 ❑ Other <br /> Project No 002 7095004 Well Mater{al ■ PVC ❑ St Steel <br /> Recorded By Greg Coffin ❑ Other <br /> WELL PURGING <br /> Purge Volume Purge Date - - C 3 Purge Method <br /> 1 Casing Diameter(D) in inches ❑ Bailer Type <br /> 0 2 inch [] 4 inch ❑ 6 inch 0 Other IRSubmersible E] Submersible Whale <br /> Total Depth of Casing(TD in feet 84 5 ❑ Other <br /> Water Level Depth(WL in feet BTOC) it�. ( _ Pump Intake Setting <br /> Number of Well Volumes(# Vols)to be <br /> 3 El 4 El 5 11 Other Near Bottom El Near lop EJ Other <br /> Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval m Feet(BTOC) from 645 <br /> � to 84 5 <br /> 845 -- CSit X 2 X 3 X 0 0409 = L -3 gallons <br /> TD(feet} WL J D(inches) #Vols Calculated Purge Volume <br /> Pump Time 1 Purge Rate Actual Purge Volume <br /> Start t�It Stop F 1 Time / <br /> Elapsed D K.� <br /> p Initial ''\ L gpm gallons <br /> Field Parameter Measurements Final Z gpm <br /> Time Galleons DO%a /L DO nn Cond I Cond 2 Salinity Tem <br /> ( g ) Y p pH Notes <br /> • Purged (umtias/cm) (umhoslcm) <br /> .21 <br /> '- <br /> [ 22c <br /> I IS } [ 1.v3 SUS <br /> Observations During Purging(well Condition TurbidityColor <br /> �Coolor Odor etc <br /> 0.j I ^�{ 1 L�r ..--lin V J r �� e+ X K--r�J L, <br /> Purge Water Storage/Disposal ❑ Drum(s) Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> Other / Comments Purge water contained in on site 1 000 galleon poly tank pending analysis/disposal <br /> WELL SAMPLING <br /> Sampled By Sampling Date _ S"- 6- C 3 Sampling Time <br /> Sampling Method ], Water Level Before Sampling(in feet BTOC) <br /> ER Bailer Type 3 I t''`t�"�"[ Jj`_ ❑ Same as Above <br /> ❑ Submersible ❑ Whale Q Grab Type <br /> ❑ Other ❑ Other Type <br /> Sampling Distribution Sample Series <br /> Sample No Containers Voi # Analysis Preservative Lab Comments <br /> INlt,r- <br /> to C _ �) - [- [.I'' ) W,11 0 S .r'u t� <br /> B C 3 J'- <br /> Other <br /> Other Notes <br />