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BLAEfCmtronntentalitilanagement,Int GROUNDWATER SAMPLING FORM <br /> 1433 North Third Atienue <br /> Phocni,,Anzona 85003 Well Not� <br /> 602 738 0707 <br /> lte ID U-Haul #709-50 Well Type ■ Monitor ❑ Remedial -VE AS <br /> C3 Other <br /> Project No---012-70950-03 Weil Material ■ PVC ❑ St Steel <br /> Recorded By f3 McDaniel ❑ Other <br /> WELL PURGINGPurge Volume Purge Date a f Purge Method <br /> Casing Diameter(D)in orchesr l• / <br /> �i <br /> 2-Inch ❑ 4-inch F16-inch ❑ Bailer-Type -J A Other — "---"—"�--• --� <br /> ❑ Submersible El Whale <br /> Total Depth of Casing(TD In feet BTOC) ❑ Other <br /> Water Level Depth(WL in feet BTOC) _5-7.g1SO I ' <br /> Number of Well Volumes(#Vats)to be Purged Pump Intake Setting <br /> N 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 /> � <br /> -1.51 a � 1 � tD— ^ J X Z 2 X X 0 0409 = 1 gallons <br /> TD(feet) WL(feet) D(inches) #Vols <br /> Calculated Purge Volume <br /> Pump Time Purge Rate JACtual Purge Volume <br /> Start 1.q0 Stop Time Elapsed f 5 Initial qpm gallons <br /> Field Parameter Measurements Final gprn <br /> Time Time Lapsed Gallons Cond 1 Cond 2 T�/ �" <br /> Purged (umhoslcm) (umhas/cm) '� Notes <br /> (16 <br /> ISS^ s Z'7 Loo 4 <br /> Observations During Purging{well 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 _B McDaniel Sampling Date LSD 1 Sampling Time <br /> Sampling Method Water Leve! Before Sampling(m feet BTOC) <br /> ■ Bader-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 # Analysis Preservative Lab Comments <br /> Other Notes <br />