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44-I BLAl EI Environmental Management,Inc GROUNDWATER SAMPLING FORM <br /> 202 East Earil Drive,Suite 478 <br /> Phoenix,Arizona 85612 Well No W <br /> ^� <br /> 602 728 0707 <br /> Well 0 Monito 0 Remedial-VE AS Recovery <br /> Site ID Well PVC 0 St Steel © Other <br /> Project No �� h Date `Z-5 —rZ Time <br /> Recorded By Sampled By <br /> WELL PURGING <br /> fCaasing <br /> e Volume Purge_ Date Purge Method <br /> Diameter(D)in inches El Bailer-Type <br /> -inch ❑ 4-inch ❑ 6-inch ❑ Other Submersible ❑ Whale <br /> Total Depth of Casing(TD in feet BTOC) act ❑ Other <br /> Water Level Depth (WL in feet BTOC) 'Llrob pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> CR pu Near Bottom El Near Top El Other <br /> 3 El 4 E] 5 El Other Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from <br /> .. . .qq..� �, 2 to <br /> To(feet) WL(feet) X #Vats X 3 X 0 0409 = ! �� gallons <br /> ( ) (inches} Calculated Purge Volume <br /> IPump Time Purge Rate JACtual Purge Volume <br /> Start 4•�O Stop S'OD Time Elapsed 3� Initial qpm Z gallons <br /> Field Parameter Measurements Final qpm <br /> Time Time Lapsed Gallons Cond 1 Cond 2 Temp pH Notes <br /> Purged (umhoslcm) (umhoslcm) <br /> Observations During Purging(well Condition,Turbidity Color,Odor,etc <br /> I <br /> Purge Water Storage/Disposal rA Drum(s), Number [] Storm Sewer ❑ Sanitary Sewer <br />' Other <br /> WELL SAMPLING <br /> Sampling Date ( L ISampling_Time <br /> 1 Sampling Method Water Level Before Sampling (in feet BTOC) - <br /> Bailer-Type ,❑ Same as Above <br />' Submersible El Whale L�Grab-Type <br /> ❑ Other ❑ Other-Type <br /> Sampling Distribution sample Series <br /> 1 Sample No Containers Vol # Analysis Preservative Lab Comments <br /> Other Notes <br />