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BLAEfCn%tronmentaltManagement,Inc <br /> 1433 North Third ANenue GROUNDWATER SAMPLING FORM <br /> Phoenix,Arizona 85003 Well No <br /> 603 728 0707 <br /> site ID LI-Haul #709-50 Well Type ■ Monitor ElRemedial -VE AS <br /> ❑ Other <br /> Project No 002-70950-03 Well Material ■ PVC ❑ St Steel <br /> Recorded Sy B McDaniel © Other <br /> WELL PURGING <br /> Purge Volume IPurge Date pj Purge Methal <br /> Casing Diameter(D) in inches ❑ Bailer-Type <br /> 2-inch ❑ 4-inch ❑ 6-inch ❑ Other <br /> ❑ Submersible ❑ Whale <br /> Total Depth of Casing(TD in feet BTOC) El Other <br /> Water Level Depth(WL in feet BTOC) Y_Zm �� �(f <br /> Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> 3 [:14 ❑ 5 ❑ Other ❑ Near Bottom ❑ Near Top Other <br /> Depth in feet(BTOC) — <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from <br /> Wig, -7 — 5­2( )7feet 30 1 2 3 to <br /> TO{feet) WL J X X X D 0409 = z gallons <br /> D(inches) #Vois Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start J1 q7 Stop t I " Time Elapsed 7 OZ� Initial Rpm ZZ gallons <br /> Field Parameter Measurements Final gprn <br /> Time Time Lapsed Gallons Gond 9 Cond 2 <br /> Purged (umhoslcm) (umhoalcm) Temp Pfi Notes <br /> Z-1_xl� o(Z' 67 <br /> Observations During Purging(well Condition Turbidity Calor, Odor etc <br /> Purge Water Storage/Disposal ❑Drum(s), Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> Other <br /> WELL SAMPLING <br /> Sampled By -I -B McDaniel Isampling Date Zr O I Sampling Time <br /> Sampling Method I Water Level Before Sampling(in feet BTOC) <br /> Bailer-Type _ 3f# Disposable ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other <br /> ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> Sample No Containers,Vol # Analysis Preservative Lab Comments <br /> Other Notes .5--PotJ- 4.0"� <br />