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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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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
Tags
EHD - Public
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v <br /> WELLHEAD MAINTENANCE LOG <br /> Client S►tE�G _Site 4.2o k�mEr��'�✓ , G d�7/ Well j�l V�1 — Z Date 1117=/�3 <br /> Does the utility box have a lid? s <br /> Is the lid broken or damaged enough to warrant replacement? hJ b Did you replace it? <br /> It is a Simple Utility box with lift type lid (non-locking) <br /> It is a__X Securable type Utility box with screw fasteners What brand? V V.C . <br /> What kind of tool is needed to open it?_ 111b S�cc <br /> Were screws in place? YfS Do Screws need to be replaced? I✓d <br /> Does the threaded receptacle reed to be repaired?_yo threads? rel&weld? A/0 <br /> Is the well lockable?yam Is there a lock? Ny f5 What type of Lock?t4-A sTFk # 335-7 <br /> Was it locked? Yee Will it unlock easily? xt��Does it need to be replaced? AVO <br /> Does the type of lid or plug have the potential to keep surface runoff water from entering the <br /> well?105 Does it appear that the plug or cap is tight enough to actually seal out water? <br /> If sealed with an expanding plug, is the plug tight enough in the top of the well to resist being <br /> readily pulled out?,Y� <br /> Did you decide that the plug should be replaced? N Did )ou replace it? <br /> Is there water present in the bottom of the box, below the top of the wellcase? IV4 <br /> Is water standing at the level of the top of the well case? AID <br /> Is water standing «ell abo%e the le-,el of the top of the wellcase? ,J 0 <br /> Do you need to bail or suck out this standing eater? k/0 <br /> Is the top of the Weil itself, cracked, bellea or deformed so a plug will not seal tightly? -►O <br /> Is any portion of the well itself, loose or aole to be readily unscrewed or pulled loose?_Mp <br /> Are there cracks or other signs of damage to the %yell, the utility box or the concrete seal? 'Vo <br /> Is there a passive recovery device (skimmer) installed in the well? V O <br /> Does it prevent a watertight seal from being installed? <br /> Is there an installed pump or other recoti ery device installed in the«yell?YD What? <br /> Does it prevent a watertight seal from being installed? <br /> Are special instructions needed for gauging or sampling this well? NO <br /> NOTES <br /> • <br /> file Wellhead sam <br />
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