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' BL A- FJ Enrironmental Management,In <br /> GROUNDWATER SAMPLING FORM <br /> 1433 rarth Third ANenue <br /> ' 'hoenn,Arizona 35003 Well No M, <br /> " <br /> 728-0707 <br /> Well Ty <br /> to ID U-Haul #709-50 pe ■ Monitor [JRernedlal -VE AS <br /> ' El Other <br /> Protect No0�0_ 002-70950- �{- Well Material ■ PVC 13 St Steel <br /> Recorded By M Hillstrom Well <br /> Other <br /> WELL PURGING <br /> Purge Volume Purge Date I _Z__7–(DZPurge Method <br /> i rr <br /> ' Casing Diameter(D)in orches Bailer-Type <br /> C1 ` <br /> 2 Inch 4-Inch ❑ 6-Inch ❑ Other Submersible <br /> ❑ Whale <br /> otal Depth of Casing(TD in feet STOC) ❑ Other <br /> Water Level Depth(WL in feet BTOC) <br /> ' Pump Intake Setting all. <br /> Number of Well Volumes(#Vols)to be Purged <br /> L 3 El ❑ 5 ❑ Other El Near Bottom ❑ Near Top [Other <br /> 7� Depth in feet(BTOC) <br /> ' Purge Volume Calutation Screen Interval In Feet(BTOC) from <br /> 92 2)8 to <br /> 3 _ <br /> TO(feet) WL(Feet) X D(Inches) X #Vols X 04Q9 gallons <br /> ' Time Calculated Purge Volume <br /> Purge Rate Actual Purge Volume <br /> Start C Stop Time Elapsed Initial qpm "�$ Z gallons <br /> Field Parameter Measurements Final qpm <br /> Time Time Lapsed Gallons Cond 1 Cane 2 <br /> ' Purgea Inc(umhosm} {umhoslcm) Temp pH Notes <br /> D � I aNa,rk`� S lt1'�z, rr �- <br /> TO <br /> ' v ' I M <br /> I <br /> 1 Observations During Purging(well Condition,Turbidity Color Odor etc <br /> Purge Wat Stora ❑Drum(s),Number ❑ Storm Sewer ❑ Sanitary Sewei <br /> ' Other <br /> WELL SAMPLING <br /> ' Sampled By I M Hillstrom Sampling Date I -Z 1-O Z Sampling Time ` 115 <br /> Sampling Method Water Level Before Sampling (in feet STOC) -,I <br /> Sailer-Type 3 ft Disposable ❑ Same as,above <br /> I <br /> ❑ Submersible Cl Whale ❑ Grab-Type I <br /> ❑ Other ❑ Other-Type ! <br /> Sampling Distribution Sample Series PG/0 Z <br /> 1 — ! <br /> Sample No Containers,Vol,# Analysis PreservativeMLab Comments <br /> 0607r Vt 0 eZ�oQ� GC_ , <br /> Other Notes <br />