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ARCHIVED REPORTS_XR0002041
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_XR0002041
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Last modified
1/30/2020 11:30:59 AM
Creation date
1/30/2020 10:48:07 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002041
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
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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DOULOS ENVIRONMENTAL, INC. SAMPLING INFORMATION SHEET <br /> Client Ultramar Sampling Date - 2 01 <br /> Site Beacon#3641 Project No <br /> 1210 E Hammer Lane 1400 Well Designation M W - 6 <br /> Stockton,Ca <br /> Is setup of traffic control devices required? � YES time hours <br /> Is there standing water in the well boxy YES Above TOC Below TOC <br /> Is top of casing cut leve] NO � If no, see remarks <br /> Is well cap sealed and locked9 NO If no, see remarks <br /> Height of«ell casing riser(ui inches) <br /> Well eo%er type 8" or ]2"UV 12"EMCO 8"or 12"BK 8"Chnsty <br /> 12"Christ} 8"M&D 12"M&D 12"DWP <br /> 12"Cl\I 36"CNI 12"Pomeco Other 12- $M { <br /> General condition of wellhead assembly Excellent Good Farr 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 X Teflon bailer Disposable Tubing <br /> Well Diameter 2" 4" 6" 8" <br /> Purge N,ol Multiplier 0 16 065 1 47 2 61 gal/ft <br /> Initial Measurement Recharge Measurement <br /> Time 6 Time Calculated purge i <br /> *Depth of well 2 Depth to water _ )S Actual purge 3 <br /> Depth to water Lf F, '? -7 <br /> Start purge Sampling time ,7 <br /> Time Temperature EC pH Turbidity Volume <br /> Ll <br /> gE0 -7 ZC <br /> -70 7 1, <br /> Sample appearance Lock <br /> Locke- f <br /> Equipment replaced (check all that apply) Note condition of replaced items) <br /> 2" Locking Cap Lock 7132 Allenhead <br /> 4" Locking Cap Lock-Dolphin 9/16 Bolt <br /> 6" Locking Cap Pinned Allenhead (DWP) <br /> �emarks <br /> Signature <br />
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