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COMPLIANCE INFO
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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(inclusive) <br />Job Number: <br />Event Date: <br />Sampler: <br />(3- 5-() <br />17155216 Client/Facility#: Chevron #9-4054 <br />Site Address: 2103 Country Club Blvd. <br />City: Stockton, CA <br />gal. x3 case volume = Estimated Purge Volume: .3 3. <br />ft <br />Time Started: (2400 hrs) <br />Time Completed: (2400 hrs) <br />Depth to Product: ft <br />Depth to Water: <br />gal. DTW @ Sampling: ( Cf/ /1.4 If yes, Time: Volume: <br />3-8-1 <br />g Ele <br />Time <br />(2400 hr.) <br />icfo <br />rt 2- <br />Conductivity <br />mS <br />t16s/cm) <br />Tscgpe rature <br />((r)/ F ) <br />Z ( • 5 <br />, <br />D.O. <br />(mg/L) <br />PRE: 0 .9 <br />ORP <br />(mV) <br />PRE: — -79 <br />Volume (gal.) pH <br />Date Monitored: 49- 2 5-f ) <br />Volume 3/4"= 0.02 V= 0 04 T-= 0 17 3. 0 38 <br />Factor (VF) 4"= 0.66 5"= 1.02 6"= 1 50 12= 580 <br />LI Check if water column is less then 0.50 ft. <br />xVF I = <br />Depth to Water w/ 80% Recharge [(Height of Water Column x 0.20) + DTW]: z 3-tte <br />Purge Equipment: <br />Disposable Bailer <br />Stainless Steel Bailer <br />Stack Pump <br />Peristaltic Pump <br />QED Bladder Pump <br />Other: <br />Start Time (purge): <br />Sample Time/Date: <br />Approx. Flow Rate: <br />Did well de-water? <br />Well Well ID <br />Well Diameter <br />Total Depth <br />Depth to Water <br />Sampling Equipment: <br />Disposable Bailer <br />Pressure Bailer <br />Metal Filters <br />Peristaltic Pump <br />QED Bladder Pump <br />Other: <br />Weather Conditions: <br />0 I cp. ) Water Color: C OdorAdj0 <br />gpm. Sediment Description: <br />Hydrocarbon Thickness: ft <br />Visual Confirmation/Description: <br />Skimmer / Absorbant Sock (circle one) <br />Amt Removed from Skimmer' ttr <br />Amt Removed from Well: ltr <br />Water Removed: ltr <br />I <br />GETTLER- RYAN INC. <br />WELL MONITORING/SAMPLING <br />FIELD DATA SHEET <br />LABORATORY INFORMATION <br />SAMPLE ID (#) CONTAINER REFR1G. PRESERV. TYPE LABORATORY ANALYSES MW-rf 6P x voa vial YES HCL EUROFINS TPH-GRO(8015)/BTEX+MTBE(8260)/ <br />TAME/1,2 DCA(8260) C..- <br />x voa vial YES HCL EUROFINS TPH-GRO(8015)/STEX+MTBE(8260)/ . <br />TAME/1,2 DCA/EDB(8260) <br />_ <br />COMMENTS: cApqnsao Q is-70 SA--if cc:--& <br />Add/Replaced Gasket: <br /> <br />Add/Replaced Bolt: Add/Replaced Lock: <br /> <br />Add/Replaced Plug: <br />
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