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BLA- EJ EmironmentaiManagement,Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third Avenue <br /> Phomik,Arixono 85003 Well No ` <br /> 02 728-0707 <br /> .)Ite 1D U-Haul #709-50 Well Type ■ Monitor EDRemedial-VE AS <br /> ❑ Other <br /> Project No 002.70950-03 WeJ Material ■ PVC ❑ St Steel <br /> Recorded By B MCDaniei <br /> ❑ Other <br /> WELL PURGING <br /> Purge Volume Purge Date Zj p( Purge Method <br /> Casing Diameter(D)in inches r �� <br /> ® Bailer-Type <br /> 2-inch ❑ 4-inch F16-inch F1 Other El Submersible <br /> Whale <br /> ❑ <br /> Total Depth of Casing(TD in feet BTOC) `7f ❑ Other <br /> Water Level Depth (WL to feet BTOC) pump Intake Setting A <br /> Number of Well Volumes(#Vols)to be Purged <br /> 2 3 ❑ 4 ❑ 5 ❑ Other ❑ Near Bottom ❑ Near Top ❑ Other <br /> Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from <br /> –71 _ — 2 to <br /> TO(Feet) WL(feet) ) X D(inches) x #vvols X D 0409 = 7. 0 gallons <br /> Calculated Purge Volume <br /> Pump Time JPurge Rate Actual Purge Volume <br /> - <br /> StartCZq I stop IL %Q Time Elapsed Initial <br /> Qpm 7 :1 gallons <br /> Field Parameter Measurements Final qpm <br /> _T;Y <br /> Time Time Lapsed Gallons Cond 1 Cond 214 <br /> Purged (umhoslcm) {umhoslcm) temp Nales <br /> 7 <br /> 2-i . <br /> Observations During Purging(well Condition,Turbidity Color Odor, etc yb ,� ,�, 41,6 <br /> Purge Water Storage/Disposal ❑Drum(s) Number [] Storm Sewer [❑ Sanitary Sewer <br /> Other -te- Pbl , <br /> WELL SAMPLING <br /> Sampled By B McDaniel Isampling Date �� �.�� p/ Sampling Time 1z$"n <br /> Sampling Method Water Level Before Sampling (in feet BTOC) 7. c) m 3 .3-7 <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 # Analysts Preservative Lab Comments <br /> AdK 17) <br /> I� <br /> Other Notes <br />