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ARCHIVED REPORTS_XR0004434
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545347
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ARCHIVED REPORTS_XR0004434
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Entry Properties
Last modified
2/6/2020 4:56:16 PM
Creation date
2/6/2020 3:40:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004434
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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M IMI =1 <br /> *ONDOREARIH <br /> CH OLOG_ _ ,_.IES <br /> 188 Frank West Circle,sults I,Stockton CA 95206 GROUNDWATER MONITORING FIELD FORM � <br /> 1 SITE: 3_- T� 4gto ec5 WELL ID: 'if l✓- 6 <br /> PROJECT NO:� 3 7�o CONDOR PERSONNEL; . t-ar <br /> AMBIENT CONDITIONS(Circle): fai adverse (describe in notes section) DATE: 3� o�- <br /> 2 FARE-PURGE DATA: Purge Volume Lmea's�ureo>detail) <br /> of casing volumes) l7 <br /> Well Cas. Depth Ift.) 2.`i- 74 (Circle �' <br /> Well Casing Diameter(in.) 2 <br /> -Depth—to—Water. 2-1.47 (subtract from well casing Depth) Measuring P int location , s. <br /> =Water Column?.BL--- _purge Vol. Calc. (for 1 casing vol.) .4s = 1. (multipliers; 2 inch=.163,4 inch=.653, 5 inch=1.02) <br /> Field inspection Sam Appearance: Odor. <br /> (Specify folar,degree of clarity,presence of sheen or product phase) (Specify slight,moderate,or sire tg) <br /> 3 PURGE DATA: Purge Device:_ fl•,5.,. L7�ya�fl� <br /> If pumped, specify_ discharge rate (gpm) depth pump set at(ft.) <br /> +IIs yotume Pureed Temnaratre PH EG If well purges dry, specify the following: <br /> AM Id (start) (cumulative) (Circle: F fo 1)time 1-f 3� <br /> Lsz� A�/" _ 1$•� 7,�� 7�.:� 2)volume purged . 6 <br /> 3) depth to water { 14 <br /> - LRM 4) depth to water for 80% recovery <br /> ——AM 11/ M 5)depth to water at time of sampling 41.5Z) <br /> Total Vol. Purged(gals.) • <br /> 4 SAMPLING DATA: No. of Contain. Tye of Gantainer Requested Analysis / <br /> —� ->f�•'�_ Time Collected W6 <br /> Collection Device�,3- iii er_ <br /> Sample ID-17,G f'11W - Gj 3 2 <br /> 5 A C SAMPLE:j, Duplicate(circle); Yes to Sample ID <br /> Rinsate on sample collection device used on this well (circle): Yes ria Sample ID <br /> 6 OECONIAMIN,A ION Method(circle Stand�ProceduI Other <br /> iStandard decorilarniriatfon procedure consists of wa gear with a solution of organic pure water and liclunex and than double rinsing with organic pure water.If another method Is used,describe in the Veld notes section.) <br /> I <br /> 7 ADDITIONAL FIE,D NOTES: <br /> I ... I <br /> O:lFormslField Farmslgwmf#lgwrrtif.xis <br />
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