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ARCHIVED REPORTS_XR0002037
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_XR0002037
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Entry Properties
Last modified
1/30/2020 11:30:55 AM
Creation date
1/30/2020 10:45:25 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002037
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
Tags
EHD - Public
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a Ab <br /> DOULOS ENVIRONMENTAL, INC, SAMPLING INFORMATION SHEET <br /> Client Ultramar Sampling Date r 0� <br /> Site Beacon #3641 Project No <br /> 1210 E Hammer Lane 1400 Well Designation /VJ w ' <br /> Stockton,Ca <br /> Is scrup of traffic control devices required 671M YES time hours <br /> Is there standing water in the well boxy YES Above TOC Below TOC <br /> Is top of casing cut lever O ' /41!0 If no, see remarks <br /> Is well cap sealed and locked r NO ISR) If no, see remarks <br /> Height of well casing riser (in inches) <br /> Well cover type 8" or 12" W 12"EMCO 8"or 12"BK 8" Christy <br /> 12" Chnsty 8"M&D 12"M&D 12"DWP <br /> � <br /> I � 36"CNI 12"Pameco Other <br /> G r coa non of wellhead assembly Excellent Goode Fair Poor <br /> Purging Equipment 2" disposable bailer Submersible pump <br /> 2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with Disposable bailer J-P Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4" 6" 8" <br /> Purge Vol Multiplier 0 16 065 1 47 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time 6 = '3 '0 Time ! I - O Calculated purge ? �. _7 <br /> Depth of well 7 0 Depth to water 'Yd' • Actual purge 9 L _ <br /> Depth to water `/ <br /> Start purge f 1 l 3__ Sampling time <br /> Time Temperature E C pH Turbidit Volume <br /> - s o - C2 <br /> 20 <br /> LX00 T / 1, <br /> Sample appearance Lock <br /> Equipment replaced (check all that apply) Note condition of replace item(s) <br /> 2" Locking Cap Lock 7132 Allenhead <br /> 4" Locking Cap Lock-Dolphin 9116 Bolt <br /> 6" Locking Cap Pinned Allenhead (DWP) <br /> Remarks <br /> Signature <br />
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