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ARCHIVED REPORTS_XR0002019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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H
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HAMMER
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1210
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3500 - Local Oversight Program
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PR0545245
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ARCHIVED REPORTS_XR0002019
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Entry Properties
Last modified
1/30/2020 11:32:00 AM
Creation date
1/30/2020 10:36:28 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002019
RECORD_ID
PR0545245
PE
3528
FACILITY_ID
FA0003730
FACILITY_NAME
TIWANA GAS & FOOD
STREET_NUMBER
1210
Direction
E
STREET_NAME
HAMMER
STREET_TYPE
LN
City
STOCKTON
Zip
95210
APN
09403012
CURRENT_STATUS
02
SITE_LOCATION
1210 E HAMMER LN
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET <br /> Client: Ultramar Sampling Date: <br /> Site: Beacon#3641 Project No.: <br /> 1210 E.Hammer Lanel400 Well Designation: <br /> 5tockton.Ca. <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in the well box? YES Above TOC Below TOC <br /> Is top of casing cut level? T=76w> If no,see remarks <br /> Is well cap sealed and locked? NOFA <br /> If no,see remarks <br /> Height of well casing riser(in inches): <br /> Well cover type: 8"or 12"UV 12"EMCO 8"or 12"BK 8"(h, ty <br /> 12"Christy8"M&.D 12"M&D 12"DWP .)/ <br /> 12"CNI 36"CNI 12"Pomeco Other: 19 <br /> General condition of wellhead assembly: Excellcut Good Fair Poor <br /> Purging Equipment: 2"disposable baiter 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: 0.16 0.65 1.47 2.61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: / 4 =34n9 Time: I I - 9 y Calculated purge: 5 <br /> Depth of well: Depth to water: 3 (- 3O Actual purge: / S� <br /> == Depth to water: 4 �' • 2 <br /> Start purge: l = Y $ Sampling time: <br /> Time Temperature E.C. 2H Turbidity Volume <br /> • � 9 bt . 3 � y , G . � 5 <br /> 11 - So fl • � 137U 6 � 5C <br /> Z <br /> 1 ! ' 5 ( 60 2 <br /> r� _ SZ- 6a . 13 2� 6• � 7 � - <br /> Sample appearance: t/C.G Lock: �-�— <br /> Equipment replaced: (check all that apply) Note condition of replaced item(s) <br /> 2"Locking Cap: Lock: 7132 Allenhead: <br /> 4"Locking Cap: Lock-Dolphin: 9/16 Bolt: <br /> 6"Locking Cap: Pinned Allenhead (DWP): <br /> Remarks: <br /> Signature: <br />
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