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gLAEfCn%ironmenialManagement,fnc GROUNDWATER SAMPLING FORM <br /> 1 433 North Third Ar enue <br /> Phoenix,Arizona 9a003 Well No 01— <br /> 602 723 0707 <br /> Well Type ■ Monitor ❑ Remedial -VE AS <br /> 101 <br /> 1 <br /> te lD IJ-Haul #709-50 - 1:1 Other <br /> Project No 002-70950-03 Well Material ■ PVC 1:1 St Steel <br /> Recorded By B McDaniel i7 Well <br /> ❑ Other <br /> WELL PURGING <br /> urge Date �j�Srl1? Purge Method <br /> Purge Volume LP <br /> y <br /> Casing Diameter(D)in inches Bailer-Type x �] <br /> 154 2-inch ❑ 4-inch ❑ 6-inch ❑ Other <br /> ❑ Submersible El Whale <br /> Total Depth of Casing(TD in feet STOC) _ �'� ❑ Other <br /> Water Level Depth(WL in feet BTOC) Pump intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> ❑ <br /> 3 El 4 El 5 El Other Near Bottom El Near Top ❑ Other <br /> Depth in feet(BTOC) <br /> Purge Volume Calulatton Screen Interval in Feet(BTOC) from <br /> 2 10 <br /> r ';9 — — �� X 7— X X 0 0409 = Z� <br /> TD(feet) Wt.(f� gallons <br /> D(inches) #Vols Calculated Purge Volume <br /> Pump Time Purge Rate JActual Purge Volume <br /> Start_Z '37 Stop Time Elapsed Initial qpm Z 0 gallons <br /> I <br /> Field Parameter Measurements Final qpm <br /> Time Time Lapsed Gallons Cond 1 Cand 2 Tem <br /> Purged (umhoslcm) (umhoslcm) p [Voles pJ4 <br /> Z J r��7 a <br /> CC �' i � l� O � �I C'S; dj r <br /> Z v -7 -7 <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 B McDaniel _ Sampling Date Z Sampling Ttme d� <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> S Bailer-Type3 ft ft Disposable ❑ Same as Above <br /> ❑ Submersible ❑ Whaley ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> Sample No Containers Vol # Analysis Preservative Lab Comments <br /> U Irma <br /> Other Notes <br />