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BL.AU Environmental Management,Inc <br /> g GROUNDWATER SAMPLING FORM <br /> 202 East Earil Drive,Suite 478 <br /> Phoenix,Arizona 85012 Well No W1 2-9 <br /> 602 728 0707 <br /> . site ID--Z29---15'D Well Type 29 Monitor El Remedial -VE AS Recovery <br /> Well Material W PVC 0 St Steel © Other <br /> Project No— ?O'J Sd-O 2— Date Time <br /> Recorded By 3_rlsl Sampled By <br /> E WELL PURGING <br /> [Purge Volume Purge Date 9 C Purge Method <br /> asing Diameter(D)in inches og Bailer-Type02-inch ❑ 4-inch ❑ 6-inch ❑ Other ❑ Submersible ❑ Whale <br /> Total Depth of Casing(TD in feet BTOC) 7 ❑ Other <br /> Water Level Depth(WL in feet BTOC) S L,�3 <br /> Pump intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> � <br /> 3 ❑ 4 E] 5 Fl <br /> [:1 Near Bottom El Near Top E] Other <br /> ] Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from <br /> ?7 <br /> 2 to Z �}3 1 X Z X X 0 0409 = gallons <br /> Tp(feet) WL{feet) J p{inches) #Vols Calculated Purge Volume <br /> Pump Time Purge Rate J Actual Purge Volume <br /> Start io 'K Stop Time Elapsed Initial gpm gallons <br /> Field Parameter Measurements Final gpm <br /> Time Time Lapsed Gallons Cond 1 Cond 2 <br /> Purged (umhoslcm) (umhos/cm) Temp Notes <br /> 12-37 zt 9 G A,- <br /> � o�� <br /> I <br /> Observations During Purging{well Condition,Turbidity,Calor, Odor,etc <br /> ,d tV ,r Zi ® � <br /> Purge Water Storage/Disposal ❑ Drum(s), Nu ber ❑ Storm Sewer ❑ Sanitary Sewer <br /> Other <br /> WELL SAMPLING <br /> Sampling Date q/" ISampling Time 6=o <br /> Sampling Method Water Level Before Sampling(in rf!Z I3 <br /> 6 Bailer-Type ❑ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other <br /> ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> I 0 �Sampfe Containers,Val ,# Analysis Preservative Lab Comments <br /> Z 6 3 <br /> li �, 2 or$ <br /> E <br /> EOther Notes <br />