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BI�ElEmtronrnenttlAlinagement Inc GROUNDWATER SAMPLING FORM <br /> 1.133 North Third %%enue <br /> 'hoemn. krimna 85063 Well No <br /> 2-728 0707 <br /> Well Type ■ Monitor ❑ Remedial -VE AS <br /> Ite ID U-Haul #709-50 ❑ Other <br /> Project No 002-70950-03 Well Material Y 0VC ❑ St Steel <br /> Recorded By. M Hllstrom ❑ Other <br /> WELL PURGING <br /> Purge Volume i Purge Date 3- 6 Z ;Purge Method <br /> Casing Diameter(D)in inches 95ailer-Type <br /> E 2-inch ❑ 4-inch [] 6-inch ❑ Other <br /> ❑ Submersible ❑ Whale <br /> Total Depth of Casing(TD in feet BTOC) ❑ Other <br /> Water Level Depth (WL in feet BTOC) 15f Z- 4— 1Purnp Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged ❑ <br /> ® 3 El ❑ 5 El Other ❑ Near Bottom [I Near Top Other <br /> Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from <br /> r '~ y 1 f ri —1 2 to <br /> `f <br /> T <br /> { � � `� n � �J X � X X a 0409 = 92_..__ gallrns <br /> TO(feet) WL(feet) D(inches) #Vols Calculated Purge Volume <br /> Pump Time I Purge Rate Actual Purge Volume <br /> Start L Stop Time Elapsed Initial qpm 2 r�� gallons <br /> Field Parameter Measurements--71 Final qpm <br /> Time Time Lapsed Galtons Cond 1 Cond 2 i Temp Notes <br /> Purged (umhoslcm) (umhoslcm) <br /> � 1 ,G SUS f lZ 3 <br /> iLA 9, 77 to U 133 <br /> Observations During Purging (well Condition Turbidity Color Odor etc <br /> Purge Water Storage/Disposal ❑Drum(s) Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> Other <br /> WELL SAMPLING ! <br /> Sampled By M Hllstrom Sampling Date Sampling Time 2 20 <br /> Sampling Method I Water Level Before Sampling (in feet BTOC) <br /> Bailer-Type 3 ft__DI_s�Osable El 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 /> 1 L VS '�— <br /> 2- 7_L <br /> Other Notes <br />