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BLAU Emtronmental N.12n2gement,Inc <br /> GROUNDWATER SAMPLING FORM <br /> 1433 No Third A%enue <br /> ' -'h0e723 nix,Arizona 35003 Well No —�C <br /> 2 0707 <br /> U-Pfau! #709-50 <br /> to 117 <br /> Well Type ■ Monitor ❑ Remedial -VE AS <br /> D Other <br /> ' Project Na_ 002-70950-qdf L'`t Well Material ■ PVC El St Steel <br /> Recorded lay M Hilstrom ❑ Other <br /> 1WELL PURGING <br /> Purge Volume [Purge Date C -(Purge Method <br /> Casing Diameter(D)in inches Bailer-Type <br /> ' ❑ 2-inch ❑ 4-inch ❑ 6-inch [—] Other ubmersibl <br /> ❑ Whale <br /> Total Depth of Casing{TD in feet BTOC} Other <br /> Water Levet Depth(WL in feet BTOC) —' <br /> ' Pump Intake Setting / <br /> Number of Well Volumes (#Vols)to be Purged <br /> ❑ Near Bottom El Near Tap ❑ Other <br /> F-1 3 El 4 E) 5 11 Other <br /> Depth in feet(BTOC) <br /> tPurge Volume Caiulation Screen interval in Feet(STOC) from <br /> 8. �;_ — . . 2 3 = IC Sto <br /> ' W�(feet)Be)� X X - X 0 0409 gallons <br /> ro(feel) ( B(inches) #Vats Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start 15.6b Stop Time Elapsed Initial f' qpm gallons <br /> ' Field Parameter Measurements Final 'v I qpm <br /> Time Time l-apsed E Gal-ins Cond 1 Cand 2 <br /> tPurged (umhoslcm) (umhoslcm) Temp pH Notes - <br /> S U z r a m•- I o I — vnr iyf <br /> 1 <br /> ' Observations During Purging(well Condition, Turbidity,Color, Odor, etc <br /> F <br /> t Storage ❑Drum(s), Number ❑ Storm Sewer ❑ Sanitary Sewei <br /> K %'VVj <br /> ELL SAMPLING <br /> d By M HllstromSampling Date -ZI - Sampling Time I [15,q 5 <br /> Sampling Method Water Level Before Sampling(In feet BTOC) � I <br /> Bader-Type _.3 ft Disposable ❑ Same as Above i <br /> ' ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other <br /> ❑ Other-Type <br /> ' Sampling Distribution Sample Series Q <br /> Sample No Containers,Vol # Analysis Preservative Lab Comments <br /> C- aZ 2— {%' G a r <br /> ' Q b01S f c <br /> ' Other Notes <br />