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BIA. E Emironmental Management Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third AN entre /'I'hoenix Arizona 85003 Well No <br /> 2 7?5-0707 <br /> Well Type ■ Monitor ❑ Remedial -VE AS <br /> ,-low <br /> ID U-Haut #709-50 ❑ Other <br /> Project No 002-70950-03 Well Materlai ■ PVC ❑ St Steel <br /> Recorded By M Hillstrom ❑ Other <br /> WELL PURGING <br /> Purge Volume J Purge Date �Purge Method l <br /> Casing Diameter(D)in inches Bailer-Type <br /> ❑ 2-Inch ❑ 4-Inch ❑ G-inch ❑ Other <br /> ❑ Submersible ❑ Whale <br /> Total Depth of Casing(TO in feet BTOC) ❑ Other <br /> Water Level Depth(WL in feet BTOC) Pump intake Setting <br /> Number of Well Volumes(#Vols)to be Purged _ <br /> ❑ Near Bottom ❑ Near Tap ❑ Other <br /> 5(3 ❑ 4 ❑ 5 ❑ Other Depth In feet(STOC) <br /> Purge Volume Calulation Screen Interval In Feet(BTOC) from <br /> r2 to <br /> i0 X � X X 0 0409 = - l gallons <br /> p(inches) <br /> 4 TO(feet) WL(feet) #Vofs <br /> l Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start I ?—I-S Stop Time Elapsed Initial qpm j 3 gallons <br /> Field Parameter Measurements Final qpm <br /> Time Time Lapsed Gallons Cond 9 Cord 2 Tem <br /> Purged (umhoslcm) (umhoslcm) p I } Notes <br /> ti <br /> 77 <br /> ZS ©a 11 Z 2 z i, <br /> Observations During Purging(well Condition Turbidity Color Odor etc <br /> Purge Water Storage/Disposal ❑Drum(s), Number [] Stori n Sewer ❑ Sanitary Sewer <br /> Other <br /> WELL SAMPLING <br /> Sampled By I M Hlfstrorn Sampling Date 7J L &Z ISamplingTime <br /> Sampling Method Water Level Before Sampling(In feet BTOC) <br /> Bailer-Type 3 ft Disposable ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> Sample No Containers Vol,# Analysis Preservative Lab Comments <br /> Other Notes <br />