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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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EHD - Public
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vti GETTLER- RYAN INC. <br /> <br />WELL MONITORING/SAMPLING <br />FIELD DATA SHEET <br />Client/Facility#: <br />Site Address: <br />Chevron #9-4054 Job Number: 17155216 <br />2103 Country Club Blvd. Event Date: (inclusive) <br />City: Stockton, Stockton, CA Sampler: C&/1 <br />Well ID MW- Date Monitored: <br />Well Diameter <br />Total Depth <br />Volume 3/4"= 0.02 <br />Factor (VF) 4. 0.66 <br />1"= 0.04 <br />5"= 1.02 <br />T= 0.17 <br />6"= 1.50 <br />3"= 0.38 <br />12"= 5.80 3 3 9 ft <br />Depth to Water 10. ft Check if water column is less then 0.50 ft. <br />2 2 -3o xVF 1 -4- = 1•R-1 x3 case volume = Estimated Purge Volume: gal. <br />Depth to Water w/ 80% Recharge [(Height of Water Column x 0.20) + orwi: / <br />Purge Equipment: <br />Disposable Bailer <br />Stainless Steel Bailer <br />Stack Pump <br />Peristaltic Pump <br />QED Bladder Pump <br />Other: <br />TimeTime Started: (2400 hrs) <br />Time Completed: (2400 hrs) <br />Depth to Product: ft <br />Depth to Water: ft <br />Hydrocarbon Thickness: • ft <br />Visual Confirmation/Description: <br />Skimmer / Absorbent Sock (circle one) <br />Amt Removed from Skimmer- fir <br />Amt Removed from Well: ltr <br />Water Removed: It <br />Sampling Equipment: <br />Disposable Bailer <br />Pressure Bailer <br />Metal Filters <br />Peristaltic Pump <br />QED Bladder Pump <br />Other <br />Start Time (purge): OMR Weather Conditions: <br />Sample Time/Date: / 6 Oc, / q/2dr+ Water Color: r t 6-4 e(..- Odor: <br />Approx. Flow Rate: — gpm. Sediment Description: A----v. A.6- <br />- <br />Did well de-water? M. (.7 If yes, Time: Volume: ------ gal. DTW @ Sampling: <br />Time <br />(2400 hr.) <br /> <br />Conductivity <br />Volume (gal.) pH ( pS / mS <br />pmhos/cm) <br />Temperature D.O. ORP <br />( C I F ) (mg/L) (mV) <br />— PRE: t• "2- PRE: — 3 9 <br /> <br />LABORATORY INFORMATION <br />SAMPLE IDOn CONTAINER ca( voa vial <br />REFRIG. PRESERV. TYPE LABORATORY ANALYSES <br />MW- Lf 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 />COMMENTS: (j j f 13 cAic- LA not late- -ro (v vr- 2`f ( be.../n/ <br />- cqi4 4 A-r,t 7 ,4K-EC-, bciri 4 ,9-/L4--ie • <br />Add/Replaced Gasket: <br /> <br />Add/Replaced Bolt: Add/Replaced Lock: Add/Replaced Plug: <br /> <br />•A-1
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