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ARCHIVED REPORTS_XR0005109
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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M
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MOFFAT
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392
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3500 - Local Oversight Program
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PR0545570
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ARCHIVED REPORTS_XR0005109
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Entry Properties
Last modified
9/23/2020 10:56:50 PM
Creation date
3/18/2020 2:46:52 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005109
RECORD_ID
PR0545570
PE
3528
FACILITY_ID
FA0009389
FACILITY_NAME
SJC DEPT OF AG - MANTECA
STREET_NUMBER
392
Direction
S
STREET_NAME
MOFFAT
STREET_TYPE
BLVD
City
MANTECA
Zip
95336
APN
221-030-08
CURRENT_STATUS
02
SITE_LOCATION
392 S MOFFAT BLVD
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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SAMPLING INFORMATION SHEET <br /> Ramage Evmromental Sampling Date <br /> P g <br /> Site AG Manteca Project No <br /> 392 South Moffat Boulevard Well Designationy(�`r <br /> Manteca, CA <br /> Is setup of traffic control devices required? YES time hours <br /> Is there standing water in the well box9 YES Above TOC Below TOC <br /> Is top of casing cut leve] NO If no, see remarks <br /> ' Is well cap sealed and locked9 NO If no, see remarks <br /> Height of well casing riser(m inches) <br /> Well cover type 8"or 12"UV 12"EMCO 8"or 12"BK 8"Chnsty <br /> 12"Christy 8"M&D 12"M&D 12"DWP <br /> 12"CNI 36"CNI 12"Pomeco Other-;�/+Zt+� <br /> General condition of wellhead assembly Excellent Good Fair Poor <br /> Purging Equipment 2" disposable bailer Submersible pump <br /> 2"PVC bailer Dedicated bailer <br /> 4"PVC bailer Centrifugal pump <br /> Sampled with Disposable bailer Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4" 6" 8" <br /> Purge Vol Multiplier 16 065 147 2 61 gal/ft <br /> Initial Measurement Recharize Measurement <br /> Time Time Calculated purge <br /> Depth of well Z Depth to water - Actual purge <br /> Depth to water <br /> Start purge Sampling time .� <br /> Time Temperature E C H Turbidity Volume <br /> /000 ez <br /> 4 <br /> 1 <br /> 40t <br /> Sample appearance Lock /�Zt <br /> Equipment replaced (check all that apply) Note condition of replaced item(s) <br /> 2" Locking Cap Lock 7/32 Allenhead <br /> 4"Locking Cap Lock-Dolphin 9/16 Bolt <br /> 6"Locking Cap Pinned Allenhead (DWP) <br /> Remarks �P ,„� dri t�✓ �/'r�l _ _ _ -- <br /> Signature. <br />
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