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ARCHIVED REPORTS_XR0003628
Environmental Health - Public
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EHD Program Facility Records by Street Name
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KETTLEMAN
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420
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3500 - Local Oversight Program
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PR0545336
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ARCHIVED REPORTS_XR0003628
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Entry Properties
Last modified
2/10/2020 5:45:13 PM
Creation date
2/10/2020 4:14:14 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003628
RECORD_ID
PR0545336
PE
3528
FACILITY_ID
FA0003776
FACILITY_NAME
KWIK SERV LODI BW 113*
STREET_NUMBER
420
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06202042
CURRENT_STATUS
02
SITE_LOCATION
420 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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WELLHEAD MAINTENANCE LOG <br /> Client S FLL Site 51Zp Well M hl -1 Date /1 z-Z 1/3 <br /> Does the utility box have a lid?-yoS' <br /> Is the lid broken or damaged enough to warrant replacement? AI0 Did you replace it? <br /> It is a Simple Utility box with lift type lid (non-locking) <br /> It is a_,y _Securable type Utility box with screw fasteners What brand? ,.v,✓e-PSAL ,,At rO cv. �v y <br /> What kind of tool is needed to open it? M4 <br /> Were screws in place?yF-!5- Do Screws need to be replaced? N n <br /> Does the threaded receptacle need to be repaired? d 0threads? wd weld? NO <br /> Is the well lockable? _L Is there a Iock? Y�"s What type of Lock?M/15 e 7 3 s7 <br /> Was it locked? YFy s Does it need to be replaced �t/o <br /> Ff «gill it unlock easily <br /> Does the type of lid or plug have the potential to keep surface runoff water from entering the <br /> well?�Zf-S Does it appear that the plug or cap is tight enough to actually seal out water?fir"S <br /> If sealed with an expanding plug, is the plug tight enough in the top of the well to resist being <br /> readily puiled out? <br /> Did you decide that the plug should be replaced' •VO Did you replace it? <br /> Is there water present in the bottom of the box, below the top of the wellcase?A/0 <br /> Is water standing at the level of the top of the well case? Mo <br /> Is water standing a ell above the level of the top of the wellcase? j/0 <br /> Do you need to bail or such out this standing water? Np <br /> Is the top of the weal itself, cracked, belled or deformed so a plug will not seal tightly? A/C <br /> Is any portion of the veli itself, loose or able to be readily unscrewed or pulled loose? HO <br /> Are there cracks or other signs of damage to the well, the utility box or the concrete seal?— <br /> Is there a passive recovery device (skimmer) installed in the well? W0 <br /> Does it prevent a watertight seal from being installed? <br /> Is there an installed pump or other recovery device installed in the well? AID What? <br /> Does it prevent a%N atertight seal from being installed? <br /> Are special instructions needed for gauging or sampling this well? dO <br /> NOTES <br /> file Wellhead sarn <br />
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