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ARCHIVED REPORTS_XR0004433
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545347
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ARCHIVED REPORTS_XR0004433
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Entry Properties
Last modified
2/6/2020 4:51:01 PM
Creation date
2/6/2020 3:39:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004433
RECORD_ID
PR0545347
PE
3528
FACILITY_ID
FA0003685
FACILITY_NAME
DBA CIRCLEK, REFUEL PETROLEUM INC.
STREET_NUMBER
419
Direction
S
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
21938610
CURRENT_STATUS
02
SITE_LOCATION
419 S MAIN ST
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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C:0NQOR EARTH TECHNO. .OG(E5 <br /> 988 Frank West Circle,Suite 1,Stockton CA 96246 GROUNDWATER MONITORING FIELD FORM <br /> 4 SITE: WELL ID: �— <br /> PROJECT NO: 3761 CONDOR PERSONNEL: s- <br /> AMBIENT CONDITIONS (Circle): fair/ dyers {d scribe in notes section) DATE: <br /> 2 PRE-PURGE DATA: Purge Volume Protocol (#of casing volumes) 3 <br /> Well Cas. Depth (ft.) .7, (Circle; measured/ Well Casing Diameter(in.) <br /> 2. <br /> Depth-to-Watl3r_ t. � <br /> (subtract from well casing Depth) Measuring Point ocation AO C <br /> =Water Column , purge Vol. Calc. (for 1 casing vol.) +74 = I. Z5 (multipliers: 2inch=.163,4 Inch=.653, 5 inch=1.02) <br /> Field Inspection Sam Appearance: r 22�C r -o� pq Odor: a <br /> (Specify color,degree of clarity,presence of sheen or product phase) (Specify sllg f,moderate,or strong) <br /> 3 PURGE DATA: Purge Device:_ D;s Zg r 6w- <br /> If pumped, specify: discharge rate(gpm) depth pump set at (ft.) <br /> TLrnke Volume Purged Temperature P{ F-C If well purges dry, specify the following: <br /> 9$L�i�1 pPM (start) (cvmulailve) (circle: F/Q 1)time <br /> UX31 LPM .7S 2,1 , Z AU5 2)volume purged <br /> 0A I�M 1 -S 12•0 6. &!5 2Ol uS 3)depth to water <br /> Q E 15---r PM 2`"2s 2 Z•5 •2 3 s O 4)depth to water for 80%recovery <br /> AM, 5) depth to water at time of sampling <br /> otal Vol, Purged(gals.) <br /> 4 SAMPLING DA'"A: <br /> . Fye- of Cont in, s •la <br /> T l%"L7TE r� <br /> Time Collected Og7 <br /> 8 vX Collection Device 's '�, <br /> Sample ID 37-Ci /YLt/ —/� L��Z <br /> 5 QAQC S a- Duplicate(circle): Yes/a Sample ID <br /> Rinsate on sample collection device used on this well (circle): Yes 145 Sample ID <br /> 6 D C NTAMINATION Method (circle); tandard Procedur /Other <br /> 4 .(Standard decontain[nation procedure consrsts of washing gear with a solurran of organic pure water and Ifquinox and then double rinsing with organic pure water.If another method Is used,describe in the(laid notes section.) <br /> 7 ADDITIONAL_FIELD NOTES: { Q roar C-'C'r, o0l <br /> O:1FormslField Formslgwmfflgwmff.xis <br />
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