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BLAUEmironmental,Management Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third 1%enue <br /> 'hoenik 1riLona 55003 Well No <br /> 02 724-0707 <br /> Well Type ■ Monitor ❑ Remedial -VE AS <br /> Wile ID U-Haul #709-50 ❑ Other <br /> Project No 002-70950-03 Well Material ■ PVC ❑ St Steel <br /> Recorded 6y M Hlistrom ❑ Other <br /> WELL PURGING <br /> Purge Volume , !Purge Date y - -o '� IPurge Method <br /> Casing Diameter(D)in Inches Bailer Type <br /> ❑ 2-inch El4-inch ❑ 6-mch [:] Other <br /> t Submersible ❑ Whale <br /> Total Depth of Casmg(TD in feet STOC) Z " ❑ Other <br /> Water Level Depth(WL m feet BTOC) H&rtCL ' Jp� ump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> ElNear Bottom ❑ Near Top ❑ Other <br /> 3 ❑ 4 [:] 5 1:1 Other Depth In feet (BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from <br /> 72 _ L2 f /� to <br /> 7b(feet) ' '� ) X X X 0 0409 = 1 ► b V gallons <br /> D(inches) #Vols Calculated Purge Volume <br /> Pump Time IPurge Rate Actual Purge Volume <br /> Start I r l C) Stop Time Elapsed Initial qpm S D gallons <br /> Field Parameter Measurements Final qpm <br /> Time Trme Lapsed Gallons Cond 1 Cond 2 <br /> Purged (umhostem) (umhoslcmem) p Notes <br /> 6 <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 I <br /> Sampled By::] _M Hlistrom Isampling Date 3 �-- Sampling Time ,moi <br /> Sampling Method Water Level Before Sampling (in feet BTOC) <br /> Bailer-Type 3 ft Dls usable ❑ 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 /> mW s <br /> Other Notes <br />