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IBLAEf Env <br /> ironmenta!Management,Inc GROUNDWATER SAMPLING FORM <br /> 202 East EDO Drive,Suite 478 <br /> Phoenit,Arizona 85012 Well No <br /> 602 728-0707 <br /> Site Ill 70 �' � 5-D Well Type ll�b Monitor 1] Remedial-VE AS Recovery <br /> Well Material 1� PVC l] St Steel O Other <br /> Project No 6c�)2r- o95' -p Date Time <br /> Recorded By Sampled By <br /> WELL PURGING <br /> Purge Volu JPurge Date � ��ay Purge Method <br /> Casing Diameter(D)in inches ❑ Bailer-Type <br /> INJ 2-inch [] 4-inch ❑ 6-Inch ❑ Other ❑ Submersible ❑ Whale <br /> Total Depth of Casing(TD in feet BTOC) _ �.J ❑ Other <br /> Water Level Depth(WL in feet BTOC)I 57, 32— W`Number of Well Volumes(#Vols)to be Purged Pump Intake Setting <br /> 3 ❑ 4 ❑ 5 ❑ Other ❑ Near Bottom ❑ Near Top ❑ Other <br /> Depth in feet(BTOC) <br /> I Purge Volume Calulation Screen Interval in Feet(BTOC) from <br /> _ 2 to <br /> , �e03z x 2 x 3 x 0 0409 `7.7 gallons <br />` ( D(inches) #Vols Calculated Purge Volume <br /> IPump Time Purge Rate Actual Purge Volume <br /> Start Stop Time Elapsed Initial gpm gallons <br /> Field Parameter Measurements Final gpm <br /> Time Time Lapsed Gallons Cond t Cond 2 <br /> Purged (umhos/cm) (umhos/cm) Temp pH Notes <br /> Observations During Purging(well Condition,Turbidity,Color, Odor,etc <br /> Purge Water Storage/Disposal [] Drum(s), Nu bei E] Storm Sewer F] Sanitary Sewer <br /> Other ll <br /> WELL SAMPLING <br /> Sampling Date 7 2C Sampling Time 16 -- t-0 <br /> Sampling Method Water Level Before Sampling(in feet BTOC) 471 Z� <br /> Bailer-Type ❑ Same as Above <br /> ❑ Submersible ❑ 4hale <br /> ❑ Other El Grab-Type <br /> ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> Sample No Containers Vol,# Analysis Preservative Lab Comments <br /> JLI W-5 400 z uD xz p <br /> lr h Lr 2 *b i <br /> Other Notes <br />