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FIAU Environmental Management,Inc <br /> GROUNDWATER SAMPLING FORM <br /> 202 East Earl[Drive,Suite 478 <br /> E Phoenix,Arizona 85012 Well No rn LJ — <br /> 602 728 4707 <br /> Well Type A Monitor O Remedial -VE AS Recovery <br /> •Site ID ']p?_ SD Well Material Off PVC IID St Steel 0 Other <br /> Protect No LI Z - ` b1,7 -b 7- Date 912—ye-i; Time <br /> Recorded By F Sampled By 6, <br /> WELL PURGING <br /> Purge Volume Purge Date q1_24. Purge Method <br /> f Casing Diameter(D)in inches Bailer-Type CZE <br /> J§ 2-inch ❑ 4-inch ❑ 6-inch ❑ Other ❑ Submersible Whale <br /> Total Depth of Casing(TD in feet BTOC) -7 -7 _ ❑ Other <br /> Water Level Depth(WL in feet BTOC) 1w,_1 2-6 Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> �3 El 4 ❑ 5 F1 Other El Near Bottom ❑ Near Top El Other <br /> Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from <br /> — S�r',7-6 2 2 3 to <br /> r 77 X X X 0 0409 = 1 Z � gallons <br /> 1 TD(feet) WL(feet) D(inches) #Vols Calculated Purge Volume <br /> `Pump Time Purge Rate Actual Purge Volume <br /> Start / Stop 7- _?e:>ftme Elapsed 7�'"►� Initial gpm f gallons <br /> Field Parameter Measurements Final gpm <br /> Time Time Lapsed Gallons Cond 1 Gond 2 TempF, Notes <br /> Purged (umhoslcm) (umhos/cm) <br /> 749 Z3. a <br /> �G 7_3 7 zea d S G- <br /> r X S'3r 22.E 1 0, �f <br /> tObservations During Purging(well Condition,Turbidity,Color, Odor,etc <br /> Purge Water Storage/Disposal [] Drum(s), Number ❑ Storm Sewer ❑ Sanitary Sewer <br /> Other Pof K � Z>-v s-y� <br /> WELL SAMPLING <br /> Sampling Date 2.g� Up ISampling Time S 2-,T- <br /> Sampling Method I Water Level Before Sampling(in feet BTOC) _S7, Z g <br /> Bailer-Type _ ❑ same as Above <br /> ❑ Submersible ❑ ahW 1e ❑ Grab-Type <br /> ❑ Other ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> Sam le No Containers,Vol,# Analysts Preservative Lab Comments <br /> U 2^ a S t <br /> d n n t•� �� D <br /> Other Notes <br />