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' BL.1E!1?nuronmentai Management,1ne <br /> � GROUNDWATER SAMPLING FORM <br /> 1433 North Third ANenue <br /> 'hoemx,Arizona 85003 Well No <br /> 2 723 0707 <br /> Well Type ■ Monitor ❑ Remedial -VE AS <br /> ite ID U-Haul #70750 ❑ Other <br /> ' Project No 002-70950-Q3' 0t Weil Material i PVC 1:JSt Steel <br /> Recorded By M hillstrom ❑ Other <br /> i WELL PURGING <br /> Purge Volume_ [Purge Qate I .2j-[3urge Method <br /> Casing Diameter(0) in inchesailer-Type <br /> 2-inch C] 4-inch ❑ 6 inch [:] Other submersible <br /> ❑ Whale <br /> otal Depth of Casing(TI] in feet BTOC) ❑ Other <br /> Water Level Depth(WL in feet BTOC) <br /> ' Pump intake Setting 1 <br /> Number of Well Volumes (#Vols)to be Purged Q <br /> ❑ <br /> El 4 [:15 ❑ Other Near Bottom ❑ Near Tap (Other <br /> J Depth in feet(BTOC) <br /> ' Purge Volume Caiulation Screen Interval in Feet(BTOC) from <br /> r� C� 2 to <br /> �V ] .ti� Z <br /> TD(feet) WL(feet) X D inches X X 0 0409ola gallons <br /> (inches) #Vs Calculated Purge Volume <br /> Rttp Time t Purge Rate Actual Purge Volume <br /> Start ISCZ Stop )'--) 3 Time Elapsed Initial qpm 9 gallons <br /> ' Field parameter Measurements Final porn <br /> Time Time LapsedF�ivallons Cond 1 Cond 2Prged (umhoslcm) {umhos/cm) Temp pH Notes <br /> olkm rnu - LIJ <br /> uv- I • >r . <br /> i <br /> Observations During Purging (well Condition,Turbidity,Color,Odor etc <br /> Purge WalStor ge EJDrum(s), Number ❑ Storm Sewer ElSanitary Sewei <br /> Other 6A L=b n Y1 fTe <br /> WELL SAMPLING <br /> ' Sampled By _ M_ Hllstrom Sampling Oate �2Z1 (�Z Sampling Time 1 s <br /> Sampling Method LJ Water Level Before Sampling(in feet BTOC) iv <br /> Bailer-Type 3 ft disposable ❑ Same as.above <br />� ' ❑ Submersible ❑ Whale <br /> ❑ Grab-Type I <br /> ❑ Other ❑ Other-Type i <br /> ' Sampling Distribution Sample Series Q6 16-2► <br /> Sample No Containers,Vol,# Analysis Preservative Lab Comments <br /> 0( Z- oo G I��r <br /> rn d150 <br /> Other Notes <br />