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ARCHIVED REPORTS_XR0004602
Environmental Health - Public
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0545482
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ARCHIVED REPORTS_XR0004602
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Last modified
3/10/2020 12:45:55 PM
Creation date
3/10/2020 8:55:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004602
RECORD_ID
PR0545482
PE
3528
FACILITY_ID
FA0005075
FACILITY_NAME
DONS MOBILE GLASS
STREET_NUMBER
151
Direction
S
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
953365719
APN
21941015
CURRENT_STATUS
02
SITE_LOCATION
151 S MAIN ST
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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A <br /> / Niek <br />' Corporation <br /> • WELL DEVELOPMENT/SAMPLING DOCUMENTATION FORM <br />' Project Name <br /> Job# S5=2ZLT1' Date <br /> Sam hn Team S <br /> (Names/Res onslbilities) <br /> rte <br /> Purpose of Sampling India] Quariy Vertcation Other <br /> Weather Conditions <br /> ' GROUNDWATER LEVEL/CASING VOLUME <br /> Depth Total Feet of Conversion Casing Volume <br /> Time TOC to QW Depth Water Factor Gallons <br /> Initial , �..x��o E(d ,fpS IO.S <br /> ' After develo 1 ur in <br /> At time of Sampling Three Casing Volumes 3 l Gals <br /> Ten Casing Volumes Gals <br /> ' WELL DEVELOPMENTIPURGING <br /> Equipment Swab-AireSub P ader,,Sandpiper Other <br /> Method Description <br /> decontamination Method <br /> Water Containm drums baker tank other <br /> Labeled <br /> ' Pum Vol Water Tem EC <br /> Observations <br /> Time Rate Extracted FIC umhas H color turbidityoils odor <br /> ' Start la U ��� <br /> G <br /> Z � I <br /> l <br /> SAMPLE INFORMATION <br /> ' Lab tom, <br /> Sampling Containers/Number of Containers/Analysis Preservation Description <br /> ' 1 Liter Amber Ice and <br /> 40 ml Vo Ice and <br /> Other Ice and <br /> ' Time _ <br /> Device DisposableBailer✓ Other <br /> �ertinent Field Observations <br /> ' Deviations from Standard Sampling Protocol! <br />
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