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BLAs`J EnwanmentalAlanagement,[nc GROUNDWATER SAMPLING FORM <br /> 1433 North Third avenue <br /> ' 'hocnix.Arizona 85003 Well No <br /> 3 738-0707 <br /> ite ID U-Haul #709-50 Well Type ■ Monitor ❑ Remedial -VE AS <br /> © Other <br /> ' Project No 002-70950-V 0'-t VVell Material i PVC ❑ St Steel <br /> Recorded By M Hilstrom ❑ Other <br /> WELL PURGING <br /> Purge Volume !Purge Date � L Purge Method / r r�r,� f <br /> C sing Diameter(D)In inches <br /> -o-z- <br /> 2 -DZtb <br /> L <br /> ' ❑ 4-inch ❑ 6-inch ❑ Other merstble e <br /> �� <br /> Total Depth of Casing(TD in feet BTOC) r C [o,, 2 b <br /> Water Level Depth(WL in feet BTOC) pump Intake Setting <br /> ' Number of Well Volumes(#Vols)to be Purged ti <br /> 3 El 4 [:15 ❑ Other ❑ Near Bottom ❑ Near Top ther <br /> Depth in(Let{BTOC} <br /> ' Purge"olume Calulatron Screen Interval in Feet(BTO , from <br /> /_� 2 to <br /> " L — SC, ZZ X C.. X - _ X 0 Q409= ��CS�i <br /> Tl)(feet) WL(feet) D(inches) #Vols gallons <br /> Calculated Purge Volume <br /> Pump Time Purge Rate JActual Purge Volume <br /> Start Stop Time Elapsed Initial qpm Z,� gallons <br /> Field parameter Measurements Final qpm <br /> Time Time Lapsed Gallons Cond 1 Cond 2 <br /> Purged (umhoslcm) (umhoslcm) I Temp phi Notes <br /> COV TC4 <br /> o r <br /> 1 F, f <br /> '2y r <br /> ' Observations During Purging(well Condition Turbidity,Color, Odor etc <br /> Purge Wate Storag Drum(s),Number (] Storm Sewer ❑ Sanitary Sewei <br /> ' ther tool <br /> WELL SAMPLING <br /> ' Sampled By M Hilstrom Isampling Date -Z 7.�Z Sampling Time l gZ <br /> Sampling Method Water Level Before Sampling(in feet BTOC) -,-- 549 <br /> Bailer-Type 3 ft Dlsg sable _ ❑ Same as Above <br /> ' ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ O her-Type <br /> 1 Sampling Distribution Sample Series pFi Z <br /> Sample No Containers,Vol,# Analysts Preservative Lab Comments <br /> 2- 6m,. W0 15 G It t- <br /> 0 15 D r <br /> I <br /> tOther Notes <br />