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BLAES EmironmentalManagement Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third A%enue <br /> Phoenix Arizona 85003 Well No MW-12C <br /> • 111 728 07(17 <br /> Well Type ■ Monitor ❑ Remedial VE AS <br /> Site !D U Haul #709 50 ❑ Other <br /> Project No 002 7095004 Well Material ■ PVC ❑ St Steel <br /> Recorded By Grep, Coffin ❑ Other <br /> WELL PURGING <br /> Purge Volume Purge Date j = o -; Purge Method I <br /> Casing Diameter(D) in inches 5kBaiier Type �c[ t t�t� l: 'h t 5- <br /> 0 2 inch ❑ 4 inch ❑ 6 inch ❑ Other <br /> ❑ Submersible ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet 85 _ ❑ Other <br /> Water Level Depth (WL in feet BTOC) _� �r Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be <br /> ❑ <br /> 3 El 4 ❑ 6 ❑ Other Near Bottom El Near Top E:1 Other <br /> Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from 65 <br /> 23 to 85 <br /> 7D 5 eq wL i X 2 X X 0 0409 = • Z gallons <br /> D(inches) #Vols Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> 1 -- - - <br /> Start Stop Time Elapsed Initial gpm r gallons <br /> Field Parameter Measurements Final gpm <br /> Time Gallons <br /> Purged DO% DO(mglL) (umh s/cm) (umhos/cin) Salinity Temp pH Notes <br /> f37_ 7v • C ; 1 -7-7 -711t, <br /> t -S ' I S f � L _ r "I I -7 3,5 <br /> �'ff 14 c � Y s T Z '-7, <br /> SZ- !Z > > 1 J Lj / br/ <br /> Observations During Purging(weil Condition Turbidity Color Odor etc { � <br /> Purge Water Storage/Disposal ❑ Drum(s), Number <br /> ❑ 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 5-- (o- b 3 Sampling Time <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> i i <br /> IR-Bailer Type _ _ +�1f!% t-k t ❑ Same as Above <br /> ❑ Submersible ❑ Whale kCGrab Type <br /> ❑ Other ❑ Other Type <br /> Sampling Distribution Sample Series <br /> Sample No Containers Vol # Analysis Preservatve S� Lab Comments <br /> '`-' <br /> 6'vt - 12- C - (-104- �f5 D LAC,6+ <br /> - a Z C. 3 LAIL S 82x.i C �k I 5e� 4C 6— <br /> Other Notes <br />