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' 1 BL AUEmironmentatIYSanagenient,Inc GROUNDWATER SAMPLING FORM <br /> 1433 North ThiFd Avenue <br /> °h..!n Arizona 85443 Well No N i <br /> il3 728 4741 <br /> Well Type ■ Monitor ❑ Remedial -VE AS <br /> Site ID U-Haul #709-50 D Other <br /> Project No 002-70950- G' Well Material ■ PVC 1:1St Steel <br /> Recorded By M Hllstrom <br /> ❑ Other <br /> WELL PURGING <br /> Purge Volume Purge Date j �, -2� Pu <br /> .o-L rge Method <br /> Casing Diameett r(D)in inches Bailer-Type <br /> ' ❑ 2-inch IX[ 4 inch ❑ 6-inch ❑ Other Submersible ❑ Whale <br /> �� , �fZ <br /> Total Depth of Casing{TD in feet BTOC} Other <br /> Water Level Depth(WL in feet BTOC) <br /> Number of Well Volumes(#Vols)to be Purged Pump Intake Setting <br /> T ❑ 4 El 11 Other [I Near Bottom [:1 Near Top El Other <br /> Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from <br /> . 810 (/ I <br /> �— X 2 X � X 0 0409 = , 10 to gallons <br /> TD(feet) WL(feet) D(inches) #Vols <br /> I Calculated Purge Volume <br /> Pump Time IPurge Rate JActual Purge Volume <br /> Start Ht't' f Stop A90 Time Etapsed Initial -� qpm n. �I� gallons <br /> Field Parameter Measurements ? Final qpm <br /> Time Time Lapsed Gallons Cond 1 4(umhos/cm) <br /> nd 2 <br /> Purged (umhoslcm) Temp pH Notes <br /> Z Zq 7 �0 <br /> .. > C _t4'�' <br /> _5 <br /> 3c�3 <br /> _ &3 CLLwv <br /> Observations During Purging(well Condition Turbidity,Color Odor etc <br /> Purge Wate Storag Tejseee0- ❑Dnim's), Number j]tS�torm Sewer ❑ Sanitary ewer <br /> Other �Db 1 r� n 5 IT-p- <br /> WELL SAMPLING <br /> Sampled By= M Hllstrom Sampling Date Sampling Time <br /> Sampling Method Water Leel Before Sampling(iii feet BTOC) "L' Lf <br /> Baler-Type _3 ft Disposable _ _ ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type I <br /> ❑ Other ❑ Other-Type <br /> Sampling Distribution Sample Series �j Z <br /> Sample No Containers Vol,# AnComments <br /> alysis Preservative Lab 1 <br /> Ank 1AG-o6vZ Z 6o C <br /> $,t 0I a <br /> Other Notes <br /> 1 - <br />