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ARCHIVED REPORTS_XR0003901
Environmental Health - Public
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EHD Program Facility Records by Street Name
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LODI
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3500 - Local Oversight Program
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PR0545420
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ARCHIVED REPORTS_XR0003901
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Entry Properties
Last modified
3/5/2020 5:28:22 PM
Creation date
3/5/2020 4:47:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003901
RECORD_ID
PR0545420
PE
3528
FACILITY_ID
FA0003815
FACILITY_NAME
TESORO (SPEEDWAY) 68154
STREET_NUMBER
2500
Direction
W
STREET_NAME
LODI
STREET_TYPE
AVE
City
LODI
Zip
95240
APN
02740006
CURRENT_STATUS
02
SITE_LOCATION
2500 W LODI AVE
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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ENGINEERING INC <br /> ACE#27011 Lic #537901 <br /> 8084 Old Auburn Fid,Suite E Citrus Heights CA 95619 <br /> IS WELL DEVELOPMENT/SAMPLING DOCUMENTATION FORM <br />' Protect Name LcyiI,lob# ��� � Well# �- <br /> Date �� , <br /> . Sample 1D <br /> Sampling Team <br /> Purpose of Sampling ❑ Initial Quarterly ❑ Venfrcation ❑ Other <br /> Weather Conditions <br /> GROUNDWATER LEVEL/CASING VOLUME <br /> Description Time Depth Conversion Casing <br /> (TOC:OC to GW) Total Depth Feet of Water Factor Volume <br /> Initial (h to ais alIons) <br /> After Development/ �� <br /> At Time of ,a Three Casing Volumes Gals <br /> � <br /> Ten Cas:ng Volumes Gals <br /> WELL DEVELOPMENTIPURGING <br /> Equipment Submersible Pump ❑ Sailer ❑ Sandpiper ❑ Other <br /> Method "}t <br /> Lhescription <br /> Decontamination Method t KLA_F— <br /> escnption <br /> Ior Containment ADM= E3gakerTank ❑Treatment System ❑Other <br /> Labeled f <br /> Start Time Volume Water Temperature --Ee-- Observations <br /> 'F/°C (umhos) PH <br /> (Color,Turbitity,OIs,Odor) <br />■ kc0 2 —4 ry ,tom <br /> 46 <br />' SAMPLE INFORMATION <br /> Lab r <br /> Sampling Containers/No of Containers Preservation <br /> -1 1 Liter Amber <br /> 40 ml VOA 7-1 ice El Other <br /> . _ t -E <br />' ❑ Other — ca ❑ Other <br /> FICS El other <br /> Device ix-Bailer Disposable El Other <br /> Pertinent Feld Observations <br /> Mons From Standard Sampling Protocol <br />
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