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ARCHIVED REPORTS_XR0002025
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_XR0002025
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Entry Properties
Last modified
1/30/2020 11:54:48 AM
Creation date
1/30/2020 10:40:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002025
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: — Q — D 7 <br /> Site: Beacon #3641 Project No.: <br /> rte:: <br /> 1210 E.Hammer Lane 1400 Well Designation; AA4 W — 3 <br /> Stockton 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? NO If no, see remarks <br /> Is well cap sealed and locked? NO 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" Christy <br /> 12"Christy8"M&D 12"M&D 12"DWP _ <br /> 12"CW 36"CNI 12"Pomeco Other: <br /> General condition of wellhead assembly: Excellent Good- Fair Poor <br /> Purging Equipment: 2" disposable bailer XSubmersible 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" 811 <br /> Purge Vol. Multiplier: 0.16 0.65 1.47 2.61 gal/ft. <br /> Initial Measurement Recharge Measurement <br /> Time: 7- Y1 Time: = t2 Calculated purge: - a <br /> Depth of well; /Y. Y/ Depth to water: Actual purge: r <br /> Depth to water: 7 <br /> Start purge: Sampling time: ! <br /> � <br /> Time Temperature E.C. pH Turbidi Volume <br /> �-3Z 2. • S 3y / . � i Z <br /> � '•�3 7 3 . 0 3 24 7 . 2. 3 <br /> 2 <br /> Sample appearance: 6A 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: 9116 Bolt: <br /> 6"Locking Cap: Pinned AlIenhead (DWP): <br /> Remarks: ' <br /> Signature: <br />
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