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ARCHIVED REPORTS_XR0004666
Environmental Health - Public
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3500 - Local Oversight Program
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PR0545482
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ARCHIVED REPORTS_XR0004666
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Last modified
3/10/2020 12:53:44 PM
Creation date
3/10/2020 9:06:47 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004666
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 <br /> . o r p o r a t I c n <br /> WELL DEVELOPMENT/SAMPLING DOCUMENTATION FORM <br /> sect Nairne <br /> to �fI <br /> molino Tedm ' t_ <br /> ' (Names/Responsibilities) <br /> pose of Sampling Initial Quarteri Verfication Other <br /> -aher,Conditions <br /> GROUNDWATER LEVEUCASING VOLUME <br /> Decth Total Feet of I Conversion Casco Volume <br /> Time TOC to GW Deoth Water I Factor I (Gallons) <br /> Initial I :5 t I l i I L <br /> After develop/ourVn 14-5a 15111 <br /> At time of 5amoli2Three Casing Volumes Gals <br /> I I Ten Casmg Volumes Gals <br /> A <br /> EVELOPMENT/PURGING <br /> �. oment Swab-Aire Sub andpiper Other <br /> ed Descnpticn sntamirlaticn Method <br /> Contain _nt rb.a prtankLabeied Vr— other <br /> r <br /> Pumo I Vol Water Temp EC I --T Observations <br /> ' Time I Rate c ^acted F/C (umhcs) I pig I (ceior turbidity ails odor <br /> start 1 A <br /> I ISI o f <br /> I I <br /> ' I 142'5 <br /> I I I I <br /> I ► I I # <br /> I I I I I I <br /> I I I I I <br /> Lab SAMPLE INFORMATION <br /> piing Containers/rAumber of Contalnersl,=,nalysis Preservation Description ' <br /> 1 Liter Amber Ica and <br /> —�� 40 ml Vca _ �— �C Ice and ' <br /> Other ice and <br /> Time <br /> Device D,sacsaole Bailer Other <br /> neat Fielo Observations <br /> ations from Standard Sam iln <br /> p g rratocol <br />
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