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Environmental Health - Public
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3500 - Local Oversight Program
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PR0545345
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Last modified
2/11/2020 6:21:35 PM
Creation date
2/11/2020 4:38:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545345
PE
3528
FACILITY_ID
FA0002994
FACILITY_NAME
NEW JERUSALEM SCHOOL
STREET_NUMBER
31400
Direction
S
STREET_NAME
KOSTER
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
25527012
CURRENT_STATUS
02
SITE_LOCATION
31400 S KOSTER RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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[ [ [ <br /> CONDOR EARTH TECHNOLOGIES <br /> GROUNDWATER MONITORING FIELD FORM <br /> 1. SITE;__.��c.� Je1'�rc�� ; �r� WELL ID: ur!4c <br /> PROJECT NO: -Z�5-00 CONDOR PERSONNEL /� 4llj - <br /> AMBIENT CONDITIONS (Circle): fair f adverse describe In notes section DATE: z 2�L-� <br /> 2. PR&URGE DATA: Purge Volume Protocol (#of casing volumes) ff <br /> Well Cas. Depth (ft.) (Circle: measured / detail) Well Casing Diameter(in,) g <br /> - Depth-to-Water (subtract from well casing depth) Measuring Point location <br /> = Water Column Purge Vol. Calc. for 1 casing vol.) - . (multipliers: 2 inch-.163, 4 inch=,653, 5 inch=1,02) <br /> Field Inspection Samole: Appearance: Odor: <br /> �Tt (SpecMy color,degree of clarity,presence of sheen.or product phaco) (Specify sAght,moderate or strong) <br /> 3. PURGE DATA: Purge Device: <br /> If pumped, specify: discharge rate (gpm) depth pump set at(ft.) <br /> Time Vol: Purged Temperatur PH E_C, If well purges dry,specify the following: <br /> ___-(start) (cumulatl+e) (circle: F / C) 1) time <br /> 2) volume purged <br /> 3) depth-to-water <br /> 4) depth-to-water for 80%recovery <br /> 5) depth-to-water at time of sampling <br /> Total Vol. Purged (gals.) .. ,..., .,..-•----- - __....._...,..._ � , <br /> 4. SAMPLING DATA: No. of Contain 'T e�of Container Requested Analysis <br /> _ —V �? „ AT IrX 7-04-(,/ g z l�6 Time Collected <br /> Collection Device S'�"pIP "r �VA we�r��orSL <br /> Sample ID__+ZSJ4- JOEV- )z/zglq <br /> b. QA/QC SAMPLE=S; Duplicate (Circle); Yes /61 Sample ID <br /> Rinsate on sample collection device used on this well (Circle): Yes I(G'), Sample ID <br /> 6. DECONTAMINATION: Method (Circle): Standard Procedure / Other <br /> (Standard decontamination procedure consist*of we shin D georwith a solution of org anic pu»water and Jl uinex and then double rinsing with organic pure water. If another method Is used,deserlbe In the field notes section.) <br /> 7. ADDITIONAL FIELD NOTES: w F( ,--Au CriU <br /> r <br /> fAforms\gwmnff.wb1 (81:35) <br />
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