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B"FJLmironmental Management Inc GROUNDWATER SAMPLING FORM <br /> 1433 forth Third l%anue <br /> ^hocnn Arizona 85003 Well No - 9A <br /> J2 728-0707 <br /> Wed Type ■ Monitor ❑ Remedla! -VE AS <br /> qWite ID U-Haul #709-50 ❑ Other <br /> Project No 002-70950-03 Well Material ■ PVC ❑ St Steel <br /> Recorded By M Hilstrom ❑ Other <br /> WELL PURGING <br /> Purge Volume I Purge Date —,I _ U"1-- IPurge Method f <br /> Casing Diameter(D)in inchesK <br /> Bailer-Type <br /> [] 2-Inch 7$4-inch ❑ 6-inch ❑ Other ❑ Submersible ❑ Whale <br /> Total Depth of Casing (TD in feet BTOC) 61 LD ❑ Other <br /> Water Level Depth(WL to feet BTOC) '79 Or Pump intake Setting <br /> Number of Well Volumes (#Vols)to be Purged El Near Top Ll Other <br /> [:1 Near Bottom <br /> 3 ❑ 4 ❑ 5 ❑ Other Depth in feet(BTOC) <br /> Purge Volume Caluiation Screen Interval in Feet(BTOC) from <br /> f to <br /> --- — �1 X r X --�-- X 0 0409 _Z gallons <br /> TO(feet) WL(feet) D(inches) #Vols Calculated Purge Volume <br /> Pump Time Purge Rate lActual Purge Volume <br /> Start Z �`) Stop 2---D Time Elapsed Initial qpm 5 gallons <br /> Field Parameter Measurements Final qpm <br /> Gallons � Cand t Cond 2 <br /> Time Time Lapsed purged (umhoslcm) (umhoslcm) Temp Notes <br /> -Z '7 ,,/ <br /> Observations During Purging(well Condition Turbidity Color Odor,etc <br /> Purge Water Storage/Disposal ❑Drum(s) Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> Other r!' eCs.�C <br /> WELL SAMPLING <br /> _Sampled By M Hllstrom ISampling Date o 2- Sampling Time <br /> Sampling Method -Water Level Before Sampling(in feet$TOC) <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 />