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EnvironmentalHealth
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EHD Program Facility Records by Street Name
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COUNTRY CLUB
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2103
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2900 - Site Mitigation Program
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PR0543854
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COMPLIANCE INFO
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Entry Properties
Last modified
6/11/2021 4:58:27 PM
Creation date
6/11/2021 3:35:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0543854
PE
2960
FACILITY_ID
FA0024935
FACILITY_NAME
FORMER CHEVRON 94054
STREET_NUMBER
2103
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12308029
CURRENT_STATUS
01
SITE_LOCATION
2103 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
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SJGOV\dsedra
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EHD - Public
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Time Started: <br /> <br />Time Completed: <br />Depth to Product: <br />Depth to Water: <br /> <br />(2400 hrs) <br />(2400 hrs) <br />ft <br /> <br />ft <br />Hydrocarbon Thickness: ft <br />Visual Confirmation/Description: <br />Skimmer / Absorbant Sock (circle one) <br />Amt Removed from Skimmer- itr <br />Amt Removed from Well: ltr <br />Water Removed: ttr <br />67 -?, 2,1 xVF / = 11(9 x3 case volume = Estimated Purge Volume: gal. 3cf, <br />Depth to Water w/ 80% Recharge [(Height of Water Column x 0.20) + DTW]: PI,I 3 <br />Purge Equipment: <br />Disposable Bailer <br />Stainless Steel Bailer <br />Stack Pump <br />Peristaltic Pump <br />QED Bladder Pump <br />Other: <br />Sampling Equipment: <br />Disposable Bailer <br />Pressure Bailer <br />Metal Fitters <br />Peristaltic Pump <br />QED Bladder Pump <br />Other: <br />E1GETTLER -RYAN INC. <br />WELL MONITORING/SAMPLING <br />FIELD DATA SHEET <br />ciientiFacility#: <br />Site Address: <br />City: <br />Chevron #9-4054 Job Number: 17155216 <br />2103 Country Club Blvd. Event Date: q, Z 5- I (inclusive) <br />Stockton, CA Sampler: <br />Well ID <br />Well Diameter <br />Total Depth <br />Depth to Water <br />him- . r- .... Date Monitored: 9- 2. S- <br />iI 4 in Volume 3/4"= 0.02 1"= 0.04 <br />Factor (VF) 4"= 0.66 5. 1.02 <br />2"= <br />6. <br />0.17 <br />1.50 <br />3.... 0.38 <br />12"= 5.80 17-cf 0 ft. <br />ft. [=)! Check if water column is less then 0.50 ft. <br />Start Time (purge): I5A C Weather Conditions: <br />Sample Time/Date: 0 / ? 5-() Water Color: C. Ce.v"--- Odor: Y• /go <br />Approx. Flow Rate. 2- gpm. Sediment Description: <br />Did well de-water? /1./0 If yes, Time: Volume: gal. DTVV @ Sampling: I 2 , C. <br />Conductivity Time Tepaperature D.O. ORP Volume (gal.) pH (f9/mS (2400 hr.) ( th F ) (mg/I.) (mV) pmhos/cm) <br />It (,,(O (04 0 414:0 Z44 PRE: 1- • I PRE: ' 34 <br />I ler2 ----T'51- 111,_ 2 4 • 0 <br />7.77r c <br />LABORATORY INFORMATION <br />SAMPLE ID (#) CONTAINER REFRIG. PRESERV. TYPE LABORATORY ANALYSES <br />MW- /C.. (e x voa vial YES HCL EUROFINS TPH-GRO(8015)/BTEX+MTBE(8260)/ <br />TAME/1,2 DCA(8260) <br />x voa vial YES HCL EUROFINS TPH-GRO(8015)/BTEX+MTBE(8260)/ <br />TAME/1,2 DCA/EDB(8260) <br />- <br />COMMENTS: ---ee ,S4Y)P1.45r4D 913 DN <br />T54-11-Ck^4r7 <br /> <br />o TD SA M /UT-S. <br /> <br />Add/Replaced Gasket: Add/Replaced Bolt: Add/Replaced Lock: <br /> <br />Acid/Replaced Plug: <br />
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