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13L*SFJ Environmental Management,Inc GROUNDWATER SAMPLING FORM <br /> 202 East Earn Dave,Suite 478 <br />' Phoenix,Arizona SS012 Well NO KAW 7 <br /> 602 725-0707 <br /> 4Site ID Well Type > Monitor 0 Remedial-VE AS Recovery <br /> 91 �q�� Well Material 99 PVC ❑ St Steel ❑ Other <br /> Project No 00-L- 7075-6-6`i- Date 4/ -7 rev Time � <br /> Recorded By Sampled By <br /> .s <br />' Purge Volume Purge Date WELL PURGING <br /> urge Method <br /> Casing Diameter(D)in inches •� <br /> EJ Bailer-Type <br /> ❑ 2-inch 4-inch [] 6-inch ❑ Other El <br /> ❑ Whale <br /> Total Depth of Casing OC ❑ Other <br /> Water Level Depth(WL in feet BTOI <br /> Number of Well Volumes(#Vols)to 6e Purged Pump Intake Setting <br /> ❑ <br /> 3 El 4 El 5 E:1 Other Near Bottom [I Near Top E] Other <br /> • 4 -- Depth in feet(BTOC) <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from <br /> I(Ir! — to <br /> TD(feet) WL(feet} X D{Inches}J t X #Vols X 00409 = gallons <br /> l <br />' Calculated Purge Volume <br /> Pump Time Purge Rate JActual Purge Volume <br /> Start Stop Time Elapsed r� Initial gpm gallons <br />' Field Parameter Measurements Final gpm <br /> Time Time Lapsed Gallons I Cond 1 Gond 2 <br />' Purged (umhoslcm) (umhoslcm) Temp pH Notes <br /> Observations During Purging(well Condition,Turbidity,Color, Odor,etc <br /> Purge Water Storage/Disposal ❑ Drum(s), Number Storm Sewer <br />' ❑ ❑ Sanitary Sewer <br /> Other <br /> WELL SAMPLING <br /> sa ISampling Time z0 <br /> Sampling Method7lWater Level Before Sampling(in feet BTOC) <br /> 0Bailer-Type I ❑ Same as Above <br /> ❑ Submersible ❑ Whale <br /> El Other ❑ Crab-Type <br /> ❑ Other-Type <br /> r Sampling Distrcbuttan Sample Series <br />!, Sample No ConnTtj!ve Lab Comments <br /> "] q tip <br /> Other Notes <br />