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1 <br /> BLL. E'1EnvlronmentalManagement,Inc GROUNDWATER SAMPLING FORM <br /> 202 East Earll Drive,Suite 478 <br /> Phoenix,Arizona 85012 Well No <br /> 602 728-0707 <br /> -70�_ - Well Type A Monitor El Remedial-VE AS Recovery <br /> Site 1D Well Material PVC 0 St Steel ❑ Other <br />' Project No (56 2 - 7&F J-6 rD`Z- pateg 4 � Time <br /> Recorded 8y , Sampled By , @� <br />' WELL PURGING <br /> Purge Volume Purge Date �f Z7 Purge Method <br /> Casing Diameter(D)in inches Bailer-Type C 2 } <br />' 1 2-Inch ❑4-inch ❑ 6-inch ❑ Other ❑ Submersible ❑ Whale <br /> Total Depth of Casing(TD in feet BTOC) 18� ❑ Other <br /> Water Level Depth(WL in feet BTOC) 5-3' bC> - Pump Intake Setting <br /> Number of Well Volumes(#Vols)to be Purged <br /> ® 3 El 4 E] 5 ❑ Other ❑ Near Bottom El Near Top El Other <br /> Depth in feet($TOC) <br />' Purge Volume Calulation Screen Interval in Feet(BTOC) from <br /> � 2 to <br /> TD(felY WL(f } X D(inches) X Vols X 0 0409 = 17, 2- gallons <br /> Calculated Purge Volume <br /> Pump Time / [Purge Rate Actual Purge Volume <br /> Start11 co Stop Time Elapsed 9'�r Initial gpm ) 7f.5;-- gallons <br /> Field Parameter Measurements Final gpm <br /> Time Time Lapsed Gallons C. 1 Cond 2 <br />' Purged (umhoslcm) (umhoslcm) Temp .pHi. Motes <br /> IObservations During Purging(well Condition,Turbidity,Color, Odor, etc /i tf�,y �,Ne— <br /> Purge Water Storage/Dtsposal ❑ Drum(s),QNumb,, ❑ Storm Sewer E] Sanitary Sewer <br /> Other if o i 4 Tte' � <br /> WELL SAMPLING <br /> Sampling Date V2--7/,o e) fSaimpling Time Ll SQ <br /> Sampling Method Water Level Before Sampling(in feet BTOC) �Z . <br /> Bailer-Type 1 [ Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other <br /> ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> Sam le No Contamers,Vol,# Analysis Preservative Lab Comments <br /> 6or� <br /> Other Notes <br />