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B��En�r A'eriu ial dfanagement,Inc GROUNDWATER SAMPLING FORM <br /> 1433 North Third Atienue <br /> 602 72\,?.rlZOna 85003 Well No Z <br /> 60?733 0707 <br /> )Ite ID U-Haul #709-50 Well Type ■ Monitor_ 1:1Remedial -VE AS <br /> 1:1 Other <br /> Protect Ne 002-70950-03 <br /> Well Material ■ PVC ❑ St Steel <br /> Recorded BY-E McDaniel <br /> ❑ Other <br /> WELL PURGING <br /> Purge VolumePurge Date �� z��pr Purge Method <br /> Casing Diameter(D)in inches <br /> ® Bailer-Type e � <br /> 2-inch yp ,X <br /> ❑ 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) <br /> Number of Weil Volumes(#Vols)to be Purged Pump Intake Setting /4 <br /> a� 3 ❑ 4 E] 5 ❑ Other El Near Bottom [I Near Top El Other <br /> Depth in feel(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(STOC) from <br /> 76 '2 — �$,(Q 1 X 2 z q to <br /> TI3 feet (feet) J X 3 X 0 0409 <br /> (feet) WL feet '' gallons <br /> �(orches) Vols. Calculated Purge Volume <br /> Pump Time Purge Rate Actual Purge Volume <br /> Start � � �3Stop �iZ�f7 Time Elapsed ` Initiat qpm <br /> grs gallons <br /> Field Parameter Measurements Final qpm <br /> Time Time Lapsed Gallons Cond 1 Cond 2 <br /> Purged (umhoslcm) (umhoslcm) Temp f Notes <br /> Z-I <br /> , 0 Oro 6 <br /> ( -2 3 �ZS7 21 <br /> r <br /> Observations During Purging(well Condition Turbidity, Color Odor etc <br /> Purge Water Storage/Disposal ❑Drum(s) Number f] Storm Sewer ❑ Sanitary Sewer <br /> Other ,O <br /> WELL SAMPLING <br /> Sampled By B MCDntel Sampling Date <br /> _. a_ P 9 �J Sampling Time <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> Bailer-Type _ 3 ft Disposable _ ❑ Same as Above <br /> ❑ Submersible ❑ Whale T <br /> El other [I Grab-Type <br /> ❑ Other-Type <br /> Sampling Distrtbutton Sample Series <br /> Sample No Containers Val , Analysis Preservative Lab Comments <br /> Other Notes <br />