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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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I�dI K <br /> • C o r p o r a t i o n <br /> WELL DEVELOPMENTISAMPLING DOCUMENTATION FORM <br /> Project Name'�7 <br /> 1 Job,# --�-�- <br /> Date <br /> Samofiu Tearn <br /> (Names/Responsibilities) <br /> Purpose of Sampling Initial uarterly Verfration Other <br /> Weather Conditions <br /> GROUNDWATER LEVELICASING VOLUME <br /> Depth Total Feet of Conversion Casing Volume <br /> Time TOC to GW Depth Water Factor I (Gallons) <br /> ' Initial tip <br /> ! ' <br /> After deveioplpur in � <br /> At time of Sampling ISC4 Three Casing Vofumes Gals <br /> Ten Casing Volumes Gals <br /> y WELL DEVELOPMENTIP URGING <br /> quipment Swab-Aire Sub Pum Bailer Sandpiper Other <br /> lethod Descnption u <br /> recontamination Method <br /> Dater Contain rums baker tank <br /> ' Label t other <br /> ' I Pumo VCI Water I Temp EC I Observations <br /> Time Rate Extracted I F/C (umhos) pH I (color turbidfty oils odor) <br /> Start I <br /> I {a r <br /> tl I I <br /> I I I <br /> f I I <br /> I I <br /> r, Lab SAMPLE INFORMATION <br /> 6 �. <br /> 3n ing Containers/Number of Containers/Analysis Preservation Description <br /> ,-� i Liter Amber Ice and <br /> _40 ml V o a fit_ r�'S"`� Ice and r <br /> ' Other Ice and <br /> Time <br /> Device Disposable Baifer�! Other <br /> °rtinent F= eld Observations <br /> viatiars from Standard Sampling Protocol <br />
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