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ARCHIVED REPORTS XR0001861
EnvironmentalHealth
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CHEROKEE
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3500 - Local Oversight Program
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PR0544482
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ARCHIVED REPORTS XR0001861
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Entry Properties
Last modified
5/21/2019 4:50:15 PM
Creation date
5/21/2019 4:34:52 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001861
RECORD_ID
PR0544482
PE
3528
FACILITY_ID
FA0000556
FACILITY_NAME
CHEROKEE LANE SERVICE STATION*
STREET_NUMBER
900
Direction
S
STREET_NAME
CHEROKEE
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04742007
CURRENT_STATUS
02
SITE_LOCATION
900 S CHEROKEE LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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DOULOS ENVIRONMENTAL COMPANY SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: 6�- 6 <br /> Site: Beacon #695 Project No. : 94-695-01 <br /> 900 S. Cherokee Lane Well Designation: MW- <br /> Lodi . CA <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? YES Above TOC Below TOC <br /> Is top of casing cut level? I If no, see remarks <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : <br /> Well cover type: 8" UV 12" UV 12" EMCO 8" BK <br /> 12" BK 12" DWP 12" CNI 36" CNI her <br /> General condition of wellhead assembly: Excellent oo Fair Poor <br /> Purging Equipment: 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer 2C .Centrifugal pump <br /> Sampled with: Disposal bailer: Teflon bailer: <br /> Well Diameter: 2" 4" 6" 8" <br /> Purge Vol. Multiplier: 0. 16 0. 65 1. 47 2 . 61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: Time: Calculated purge: �• � <br /> Depth of well:�6f! _ Depth to water: 6 6 �t _ Actual purge: <br /> Depth to water: ULOT <br /> Start purge: 601- Sampling time: 6 <br /> Time Temp. E.C. pH Turbidity Volume <br /> 605 <br /> 1- / 1-?-1- 7 il <br /> /.1-01 2 <br /> 6/3 i_:�)� 7a- <br /> Sample appearance: ' �L Lock: 7 d <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Cap: Lock ,#3753 : 7/32 Allenhead: <br /> 411 Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks: <br /> 1 ire <br /> Signature: <br />
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