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ARCHIVED REPORTS_XR0003906
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_XR0003906
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Entry Properties
Last modified
3/5/2020 6:47:02 PM
Creation date
3/5/2020 4:49:10 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003906
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
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EHD - Public
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A <br /> 1 � <br /> Park f <br /> Environmentalil <br /> Leaving A Clean Environment <br /> WELL DEVELOPMENT/SAMPLING DOCUMENTATION FORM <br /> Project Name ' <br /> .job# <br /> Date <br /> Sate lin eam <br /> (Names/Responsibilities) <br /> Purpose of Sampling Inittat Quarterly Verrication Other <br /> Weather Conditions <br /> GROUNDWATER LEVEL/CASING VOLUME <br /> Depth Total Feet of Conversson Casinu Volume <br /> Time TO t GW Depth Water Factor Gallons <br /> Initial r2 58•'Z 147,00 <br /> After devefo / ur in Gals <br /> At time of Sam lin Three Casing Volumes r <br /> Ten Casing Volumes Gals , <br /> WELL DEVELOPMENT/PURGING <br /> Equipment Swab-Aire �SubP Bader r Sandpiper Other <br /> Method Description ant I-LD <br /> Decontamination Method <br /> Water Contac en rums baker tank other <br /> Labeled b <br /> Pump Vol Water —T m EC Observations <br /> Time Rate Extracted (umhos) PH c ior,turbidi ,oils,odor <br /> Start r ' <br /> ( 2 5' 2 'a <br /> SAMPLE INFORMATION <br /> Lab ¢A� <br /> Sampling Containers/Number of Containers/Analysis Preservation Description <br /> 1 Liter Amber ice and <br /> 40 ml Voa { - h 4 _ _�E Ice and <br /> Other ice and <br /> Time <br /> Device Disposable Bailer Other <br /> Pertinent Field Observations <br /> Deviations from Standard Sampling Protocol <br />
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