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ARCHIVED REPORTS XR0006868
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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E
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103
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3500 - Local Oversight Program
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PR0544638
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ARCHIVED REPORTS XR0006868
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Last modified
7/9/2019 3:38:08 PM
Creation date
7/9/2019 1:52:59 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006868
RECORD_ID
PR0544638
PE
3528
FACILITY_ID
FA0004027
FACILITY_NAME
HENDRIX FORK LIFT INC
STREET_NUMBER
103
Direction
N
STREET_NAME
E
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
15318001
CURRENT_STATUS
02
SITE_LOCATION
103 N E ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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WATER SAMPLE FIELD DATA SHEET "e", <br /> 3190 <br /> PROJECT NO: SAMPLE ID: <br /> PURGED BY: CLIENT NAME: <br /> SAMPLED BY: LOCATION: <br /> TYPE: Ground Water Surface Water Treatment Effluent Other <br />' CASING DIAMETER (inches): 2 3 4 4.5 6 Other <br />' CASING ELEVATION (feeVMSL) : VOLUME IN CASING (gal.) : <br /> DEPTH TO WATER (feet) ,. CALCULATED PURGE (gal.) : <br />' DEPTH OF WELL (feet) : ACTUAL PURGE VOL. (gal.) <br /> DATE PURGED: Start(2400) End(2400) <br /> DATE SAMPLED: Start(2400) End(2400) <br /> TIME VOLUME pH E.C. TEMPERATURE COLOR TURBIDITY <br /> (2400 Hr) (gal.) (units) (µmhos/an@ 25°C) (°F) (visual) (visual) <br /> s <br /> } D. O. (ppm): ODOR: <br /> (COBALT o-1oa) (�Tuo-2a0} '3 <br /> FIELD DC SAMPLES COLLECTED AT THIS WELL ('i.e. FB-1, X-DUP-1) <br /> PURGING EQUIPMENT SAMPLING EQUIPMENT <br /> 2'Bladder Pump Bailer(TeflonO) 2'Bladder Pump Baiter(Teflon®) <br /> Centrifugal Pump Bailer(PVC) DDL Sampler Bailer(Stainless Steel) <br />' Submersible Pump Bailer(Stainless Steel) Dipper Submersible Pump <br /> Well WizardTM Dedicated Well Wizardrm" Dedicated <br /> Other: Other: <br />' WELL INTEGRITY ' LOCK# : <br /> REMARKS: <br /> 1 <br /> Meter Calibration: Date: Time: Meter Serial# Temperature <br />' (EC 1000 1 ( DI H2O )(pH 7-1-)(pH 10 ! )(pH 4_1-) <br /> SIGNATURE Reviewed by: <br /> �1 EMCON FIGURE <br /> Associates WATER SAMPLE FIELD DATA SHEET C-2 <br /> 1 '*"' <br />
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