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ARCHIVED REPORTS_XR0004603
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545482
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ARCHIVED REPORTS_XR0004603
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Entry Properties
Last modified
3/10/2020 12:06:04 PM
Creation date
3/10/2020 8:55:25 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004603
RECORD_ID
PR0545482
PE
3528
FACILITY_ID
FA0005075
FACILITY_NAME
DONS MOBILE GLASS
STREET_NUMBER
151
Direction
S
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
953365719
APN
21941015
CURRENT_STATUS
02
SITE_LOCATION
151 S MAIN ST
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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e <br /> pArk <br /> Corparatian ' <br /> WELL DEVELOPMENT/SAMPLING DOCUMENTATION FORM • <br /> Project Namll��. LLA . I A sg !y-ol.�1r�- <br /> Job# <br /> Date i Z i�' — � fa •- _ __ _ ' <br /> Sampling Team lL i k- ,[- k/ _ <br /> (Names/Responsibilities) ' <br /> Purpose of Sampling Initial carted Verfication Other <br /> Weather Conditions <br /> GROUNDWATER LEVEL/CASING VOLUME ' <br /> Depth Total Feet of Conversion Casing Volume ' <br /> Time TOC to GW Depth Water Factor Gallons <br /> Initial a J' _ --� -� ire <br /> }, <br /> After develo 1 ur in <br /> At time of Sampling /t 17 :? Three Casing Volumes Gals ' <br /> Ten Casing Volumes Gals <br /> WELL DEVELOPMENT/PURGING ' <br /> Equipment Swab-Aire ub Pum Bailer Sandpiper Other <br /> Method Description <br /> Decontamination Method 42 i Q c. <br /> Water Containment dr baker tank other- <br /> Labeled <br /> therlabeled <br /> Pump Vol Water Temp EC Observations ' <br /> Time Rate Extracted F� mnpes MY y color turgid oils odor <br /> Start • G" �? -J y ' <br /> 7 7.e7 7 <br /> �q w <br /> SAMPLE INFORMATION <br /> Sampling Containers/Number of Containers/Analysis Preservation Description <br /> 1 Liter Amber Ice and <br /> 40 ml Voa -#- ce and I <br /> Other Ice and <br /> Time ' <br /> Device Disposable Bailer Other <br /> Pertinent Field Observations <br /> Deviations from Standard Sampling Protocol <br />
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