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ARCHIVED REPORTS_XR0012511
Environmental Health - Public
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3500 - Local Oversight Program
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PR0545509
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ARCHIVED REPORTS_XR0012511
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Last modified
3/11/2020 7:14:10 AM
Creation date
3/10/2020 3:57:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012511
RECORD_ID
PR0545509
PE
3528
FACILITY_ID
FA0002121
FACILITY_NAME
JAMAR SERVICE
STREET_NUMBER
4075
Direction
E
STREET_NAME
MAIN
STREET_TYPE
ST
City
STOCKTON
Zip
95215
APN
15726411
CURRENT_STATUS
02
SITE_LOCATION
4075 E MAIN ST
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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• WELL DEVELOPMENT/SAMPLING DOCUMENTATION FORM <br /> Project Name: -S- ,•- Job #__S!4 Well# <br /> Dates: I ( -- r)3 Samples 10: <br /> ling Team: "YI uakj dZ4-'J <br /> pose of Sampling: ❑ Initial '$L Quarterly ❑ Verification Other: <br /> Weather Conditions:_ 54)1717y. <br /> GROUNDWATER LEVEL/CASING VOLUME <br /> Conversion Casing <br /> Description Time Depth Total Depth Feet of Water Factor Volume <br /> TOC to GW) ft, togals.) (gallons) <br /> Initial (05-co -7 3 <br /> Atter development) <br /> Pur in <br /> At Time of Three Casing Volumes y a Gals <br /> Sampling Ten Casing Volumes Gals <br /> WELL DEVELOPMENT/PURGING <br /> Equipment: 9-Submerisible Pump Cl Bailer Cl Sandpiper Other: <br /> Method' a•r /fir 4 <br /> Description <br /> Decontamination Method: P JZ;n <br /> Description <br /> Water Containment: Drums [i Baker`dank . ❑' Treatment System ❑ Other: <br /> Start Time Volume Water Temperature EC pH Observation <br /> Extracted °F!°C mV Color,Turbitily, Oils, Odor <br /> 3 v d '�- <br /> 7 -7 :(- s . <br /> � '•(3 �r 3 a, v K <br /> SAMPLE INFORMATION <br /> Lab: vn Si`A-vt <br /> Sampling Containers/No. of Containers Preservation <br /> ❑ 1 Liter Amber ❑ Ice ❑ Other <br /> "0 ml VOA ❑ Ice ❑ Other <br /> 0 Other ❑ Ice ❑ Other <br /> Device: AtBai[er, Disposable ❑ Other <br /> Pertinent Observations: <br /> tions From Standard Sampling Protocol. <br /> GHH ENGINEERING INC. <br /> 11960 Heritage Oak Place, Suite 213,Auburn, CA. 95603 (830) 886.3100 <br />
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