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ARCHIVED REPORTS_XR0005110
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_XR0005110
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Entry Properties
Last modified
9/23/2020 10:58:53 PM
Creation date
3/18/2020 2:47:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005110
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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INFORMATION SHEET <br /> Client Ramage Evniromental Sampling Date ` d t/ <br /> Site AG Manteca Project No <br /> 392 South Moffat Boulevard Well Designation 3 <br /> Manteca, CA <br /> Is setup of traffic control devices required9 YES time hours <br /> Is there standing water iii the well box`s 1F.S Above TOC Below TOC <br /> Is top of casing cut leve] NO If no, see remarks <br /> Is well cap sealed and lockedg / NO if no,see remarks <br /> Height of well casing riser(in inches) 6 <br /> Well cover type 8"or 12"UV 12"EMCO 8"or 12"BK 8"Christy <br /> 12"Chnsty12"M&D 12"DWP <br /> 12"CNI 36"CNI 12"Pomeco Other <br /> �i General condition of wellhead assembly Excellent Good__X Fair Poor <br /> ■ Purging Equipment V 2" disposable bailer Submersibleum <br /> p p <br /> 2"PVC bailer Dedicated bailer <br /> 4"PVC bailer Centrifugal pump <br /> Sampled with Disposable bailer�� Teflon bailer Disposable Tubing <br /> �4 Well Diameter 2" 4" 6" g» <br /> �( Purge Vol Multiplier 016 065 147 2 61 gal/ft <br /> Initial Measurement Rechar a Measurement <br /> Time V : Time Z r _ r Calculated purge j <br /> Depth of well Z. Depth to water _ , � Actual purge , <br /> Depth to water 2 C* <br /> Start purge 0 Sampling time <br /> Time Temperature EC H Turbidi Volume <br /> 3 3 0 9 / �. 2 <br /> Sample appearance _ Lock <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 (D WP) <br /> . Remarks <br /> Signature <br />
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