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ARCHIVED REPORTS_XR0004606
Environmental Health - Public
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3500 - Local Oversight Program
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PR0545482
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ARCHIVED REPORTS_XR0004606
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Last modified
3/10/2020 12:02:38 PM
Creation date
3/10/2020 8:56:54 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004606
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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1 /A <br /> Park <br /> Environmental <br /> Ing A Clean Environment <br /> WELL DEVELOPMENT/SAMPLING DOCUMENTATION FORM <br /> Protect Nam 2 _ C� �y' <br /> Job# NA <br /> Date f <br /> Sampling Tem <br /> ' (Names/Responsibilities) <br /> Purpose of Sampling Initial �Quarterly Verfiicatlon Other <br /> Weather Conditions <br /> GROUNDWATER LEVEL/CASING VOLUME <br /> Deth Total Feet of Conversion Casino Volume <br /> Initial <br /> Time TOC to GW Depth Water Factor Gallons <br /> ' After develo / ur inJ �O <br /> At time of Sam lin Three Casing Volumes <br /> _ ;�Z Gals <br /> Ten Casing Volumes Gals <br /> WELL DEVELOPMENT/PURGING <br /> Equipment Swab-Aire Sub Pump Bailr andpiper Other <br /> Method Description u i ck <br /> DecontaminatiopMelt,hod <br /> Water Contain nt drum `-.� baiter tonic other <br /> Labeled jc� <br /> Pump Vol Water Tem EC Observations <br /> Time Rate Extracted F)Cumhos H calor turbidityoils odor <br /> l <br /> Start otd <br /> ,q r <br /> ' <br /> Lab � <br /> SAMPLE INFORMATION r t+ � <br /> Sampling Containers/Number of Containers/Analysis Preservation Description <br /> 1 Liter Amber r-, Ice and <br /> 1-2) 40 ml Voa Ice and t-=C-t— <br /> Other - Ice and <br /> ' Time <br /> � Device Disposable Bailer Other <br /> ertinent f=ield Observations <br /> Deviations from Standard Sampling Protocol <br />
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