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ARCHIVED REPORTS XR0007512
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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EL DORADO
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141
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3500 - Local Oversight Program
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PR0544645
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ARCHIVED REPORTS XR0007512
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Entry Properties
Last modified
7/11/2019 11:30:33 AM
Creation date
7/11/2019 10:30:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007512
RECORD_ID
PR0544645
PE
3528
FACILITY_ID
FA0004979
FACILITY_NAME
CIVIC CENTER PARKING*
STREET_NUMBER
141
Direction
N
STREET_NAME
EL DORADO
STREET_TYPE
ST
City
STOCKTON
Zip
95202
APN
13909002
CURRENT_STATUS
02
SITE_LOCATION
141 N EL DORADO ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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T <br /> - 1► .1 <br /> WELL HEAD INSPECTION CHECKLIST AND REPAIR ORDER <br /> Client S)jf=Lt t-- Site# 2-A4-76.Z4 -/S Inspection date. 7 Z(p <br /> Site address Inspected by-_ ` <br /> -% .- <br /> STS Event 4F -moi �' —1 2 <br /> Z Lid on the box'7 Yes No 5 Water standing in the well box? 7 Can cap be pulled loose? <br /> 2 Lid whole? 5a. Standing above well top? 8 Can cap seal out water? <br /> 3 Lid secure'? 5b. Standing below well top? 9 Padlock present*2 <br /> 4 Lid seal intactl 5c Water even with top of well cap? 10. Padlock found iockedl <br /> S. Well cap/plug present? 11 Padlock functional? <br /> Check box if no deftcrences were found. Note below deficiencies you were able to correct. <br /> Well I.D_ Deficiency Corrective Action Taken <br /> FLO Z I G CAP { .SA{► 6- 1v76�s <br /> �''� <br /> No W, Ltd �0 `u us I 1��� 2 7 sn cw►,� <br /> I i <br /> I I <br /> Note below all defrciences that could not be corrected and still need to be corrected. <br /> BTS Office assigns or Date Date <br /> Well I.D. Persisting Deficiency defers Correction to: assigned carrected <br /> 2ab I <br /> I <br /> I <br /> � I <br /> I I f <br /> I <br /> I <br /> Office review and assignments made by date <br /> Blaine Tech Services, Inc. File WELLCHK.s <br />
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