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' B V.�E!Environmental Management,Inc <br /> g GROUNDWATER SAMPLING FORM <br /> 202 East Earl[Drive,Suite 478 <br />' Phoenix,Ari2ona 85012 Well No 4t�J — g <br /> 602 728-0707 <br /> Site IDQ �7-s� Well Type V Monitor © Remedla[-VE AS Recovery <br /> Well Material 0 PVC ❑ St Steel 0 Other <br /> Project No ODS-?y 9S -p I Date ZZ oo Time t i Cc <br /> Recorded By Sampled By , <br /> WELL PURGING <br /> Purge Volume Purge Date Z"? Purge Method <br /> Casing Diameter(D)in inches ❑ Bailer-Type <br /> ❑ 2-inch W4-inch ❑ 6-inch ❑ Other �ubmersibie ❑ Whale f- - <br /> Total Depth of Casing(TD in feet BTOC) $5_ "r- � `- �.. ❑ Other � Z_" Q C <br /> Water Level Depth (WL in feet BTOC) f ? �! <br /> Number of Wel!Volumes(#Vols)to be Purged Pump Intake Setting <br /> 29 3 ❑ 4 ❑ 5 ❑ Other Near Bottom EJ Near Tap ❑ Other <br /> Depth in feet(BTOC) �.a--.-�3 <br /> Purge Volume Calulation Screen Interval in Feet(BTOC) from <br /> 2 to S� <br /> TD(feet WL feet ) X A- X X 00409 = 65- gallons <br /> (feet) D(inches) #Vols Calculated Purge Volume <br /> Pump Time Purge Rate Actual purge Volume <br /> Start 14)'5 top j Z- Time Elapsed +-!+::�Lt4*`Initial gpm 6,IV 9 allons <br /> Field Parameter Measurements r Final gpm <br /> Time Time Lapsed Gallons Cond 1 Cond 2 <br /> Purged (umhoslcm) (umhoslcm) Temp ,Ai. Notes <br /> ,05- I ( to lot I Z[ Z3 8 e. 5- V. Z ) /e- SU470 <br /> 2_-2' 2AE:> 91-01 C'3.' 2-3.q 0,5' <br /> .z7 3 3 3e G2r e� <br /> it ,31F 61, 1 9j5� <br /> 4 9 <br /> 6. <br /> lz ►� �g <br /> Observations During Purging(well Condition,Turbidity, Color,Odor,etc ^(,,JkA�e=4!��j5-1 7p " <br /> Purge Water Storage/Disposal ❑ Drum(s), Num er [] Storm Sewer ❑ Sanitary Sewer <br /> Other e.4K <br /> WELL SAMPLING <br /> Sampling Date L7 ooSampling Time 1 Z !'D <br /> Sampling Method Water Level Before Sampling(in feet BTOC) <br /> f rP>k <br /> Bailer-Type P A Same as Above <br /> ❑ Submersible ❑ Whale ❑ Grab-Type <br /> ❑ Other <br /> ❑ Other-Type <br /> Sampling Distribution Sample Series <br /> Sample No Containers,Vol,# Anal sis Preservative Lab Comments <br /> dal 82 • zS <br /> OW-A_q6D - z40 <br /> Other Notes <br />