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BLAEfEntiironmeniniNfanagement,Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third Asenue <br /> Phoenix,Arizona 33003 Well No C�-- <br /> 602 723 0707 <br /> >ffz ID U-Haul #709-50 Well Type ■ Monitor I] Remedial -VE AS <br /> © Other <br /> Project No 002-70950-03 Well Material ■ PVC D St Steel <br /> Recorded BY___9 McDaniel E Other <br /> WELL PURGING <br /> Purge Volume Purge Date Purge Method <br /> Casing Diameter(D)in inches <br /> F-12-inch g?4-inch [IS-inch ❑ Other ❑ Bailer-Type <br /> Submersible�❑ Whale <br /> Total Depth of Casing(TD in feet BTOC) El Other 2--- <br /> Water <br /> —"Water Level Depth(WL In feet BTOC) ,5�� o <br /> 6 Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> IQ 3 ❑4 ❑ 5 ❑ Other L] Near Bottom ❑ Near Top Other <br /> Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from <br /> r D f e ,( X X 0 0409 <br /> L� z �? to <br /> 4l TC(feet) WLL(feet) h` = 7 gallons <br /> D(inches) #Vols Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volum <br /> ie <br /> Start r "51 Stop J-'(6 Time Elapsed Initial qpm gallons <br /> Field Parameter Measurements Final qpm <br /> Time Time Lapsed Gallons Cond t Cond 2 <br /> Purged (umhaslcm) (umhoslcm) Temp Notes <br /> Z a «v <br /> Zi <br /> 2, � �� '7 z3! <br /> Observations During Purging(welt 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 I B McDaniel Sampling Date '� Z 6/p Sampling Time Z <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> Bailer-Type 3 ft Disposable ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other <br /> ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> Sample No Containers,Vol # Analysts Preservative Lab Comments <br /> 2U I M r� <br /> 1 1- J do <br /> Other Notes <br />