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ARCHIVED REPORTS_XR0003915
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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L
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LODI
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2500
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3500 - Local Oversight Program
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PR0545420
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ARCHIVED REPORTS_XR0003915
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Entry Properties
Last modified
3/5/2020 5:51:07 PM
Creation date
3/5/2020 4:52:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003915
RECORD_ID
PR0545420
PE
3528
FACILITY_ID
FA0003815
FACILITY_NAME
TESORO (SPEEDWAY) 68154
STREET_NUMBER
2500
Direction
W
STREET_NAME
LODI
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
02740006
CURRENT_STATUS
02
SITE_LOCATION
2500 W LODI AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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SAMPLING INFORMATION SHEET <br /> Client : <br /> Sampling Date : 00 <br /> � site : 50 Q.. ' <br /> Project No . : <br /> Well Designation : 57 <br /> Is setup of traffic control devices required? T�O YES time : <br /> Is there standing water in well box? 4 hours <br /> Is top of casing cut level? � Above TOC Below TOC <br /> Is well cap sealed and locked? NO �EL9 If no, see remarks <br /> Height of well casing riser (in inches) : YES If no, see remarks <br /> Well cover type : 8" W 12 " W <br /> 12 " BK 12" DWP 12" EMCO 8" BK <br /> 12" CNI 36" CNI Other I'o <br /> General condition of wellhead assembly: ExcellentFit) Fair Poor <br /> Purging Equipment: 2 " disposable bailer <br /> „ Submersible pump <br /> 2 PVC bailer Dedicated bailer <br /> 4 " PVC bailerCentrifugal pump <br /> Sampled with: Disposal bailer ; Teflon bailer : <br /> Well Diameter : 2" z2 4,r <br /> Purge Vol . Multiplier: 0 . 1.6 yy 0 . 65 1. 47 2 . 61 gal/ft . <br /> 4 Initial Measurement Recharge Measurement <br /> Time : 1(703 Time ., Calculated purge : 7 <br /> Depth of weft : 7-3 Depth to ater :__� <br /> Depth to water: Actual purge : rJ� <br /> "'"` <br /> start purge :_/ � �] Sampling time : /4,jf, <br /> Time Temp. E. C. pH Turbidity Volume <br /> I 70,E 7JI <br /> Sample appearance : Lock : <br /> Equipment replaced : (Check all that apply) Note condition of replaced item <br /> 2 " Locking Cap: Lock 03753 : 7/32 Allenhead: <br /> 4 " Locking Cap: Lock-Dolphin: 9/16 Bolt : <br /> 6" Locking Cap: Pinned Allenhead (DWP) : <br /> Remarks : <br /> Signature : <br />
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