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g * E Entirronmenrat,tilanagement,inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third At enue <br /> PlroenryArzzona 35003 Well NoISS <br /> 602 723 0707 <br /> ,Ito ID U-Haul #709-50 Well Type ■ Monitor EJ Remedial-VE AS <br /> Project No 002-70950-03 ❑ Other <br /> Recorded 13y B McDanielWell Material ■ PVC El St Steel <br /> 0 Other <br /> WELL PURGING <br /> Purge Volume Kg7eD7ate 11 -2: Purge Method <br /> Casing Diameter(D)in inches <br /> 2-inch � Bailer- Type <br /> N ❑ 4-inch ❑ 6-inch ❑ Other ❑ Submersible <br /> ❑ Whale <br /> Total Depth of Casing(TD In feet BTOC) ❑ Other <br /> Water Level Depth (WL in feet BTOC) 57 3E, 9 1{ oLt <br /> Number of Well Volumes(#Vols)to be Purgad Pump Intake Setting <br /> ❑ <br /> 3 ❑ 4 ❑ 5 ❑ Other Hear Bottom El Near Top ❑ Other <br /> Depth in feet(BTOC) <br /> Purge Volume Calulalion Screen Interval in Feet(BTOC) from <br /> 5—? Z 10 <br /> TD(Feet} WL(root) ) X X 3 X 0 0409gaflDns <br /> o(inches) #Vols Calculated Purge Volume <br /> Pump Time { Purge Rate Actual Purge Volume <br /> Start LL Stop !i ,3 Time Elapsed Ll Initial gprn <br /> © gallons <br /> Field Parameter Measurements Final qpm <br /> Time Time Lapsed Gallons Cond 1 Cond 2 <br /> Purged (umhoslcm) (umhos/cm} Temp Notes <br /> Observations During Purging(well Condition,Turbidity,Color Odor etc <br /> I <br /> Purge Water Storage/Disposal []Drum(s) Number <br /> ❑ Storm Sewer ❑Sanitary Sewer <br /> Other <br /> WELL SAMPLING <br /> Sampled 13y 8 McDaniel -:ampling Date �1 Z� or Sampling Time <br /> Sampling Method Water Level Before Sampling (in feet STOC) <br /> S Bailer-Type 3 ft Disposable ❑ Same as Above <br /> ❑ Submersible ❑ Whale �J <br /> ❑ Other El Grab-Type <br /> ❑ Other-Type <br /> Sampling Dlstrlbutitaf Sample Series <br /> Sample No Containers,Vol # Analysis Preservative Lab Comments <br /> 41w- 017 <br /> i I <br /> I <br /> Other Notes <br />