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ARCHIVED REPORTS_XR0008889
Environmental Health - Public
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EHD Program Facility Records by Street Name
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UNION
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3500 - Local Oversight Program
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PR0545776
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ARCHIVED REPORTS_XR0008889
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Entry Properties
Last modified
6/1/2020 11:46:46 AM
Creation date
6/1/2020 11:37:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008889
RECORD_ID
PR0545776
PE
3528
FACILITY_ID
FA0002231
FACILITY_NAME
JACK FROST ICE SERVICE
STREET_NUMBER
425
Direction
N
STREET_NAME
UNION
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
15112003
CURRENT_STATUS
02
SITE_LOCATION
425 N UNION ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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LSauers
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EHD - Public
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10/01/1.998 15 33 9167829054 <br /> DOULOS PAGE 06 <br /> DOVL08 EMVIRONMENTAL COMPANY <br /> SAMPLING INFORMATION SHEET <br /> A <br /> Client: 't Sampling Date; -q <br /> Site: 1 + fty Project No. .. <br /> Well Designation: <br /> to f on <br /> Is setup of traffic control devices required? YES time: hours <br /> Is there standing water in well box? <br /> za top of casing Cut level? YES Above TOC BelowTOC <br /> Is well cap sealed and locked? NO If no, see remarks <br /> Height of well casing riser (in inches) : NO If no, see remarks <br /> Well Cover type: a t$ uv 12 of UV _ i Z+� EMco <br /> tr —�� 8" BK <br /> 12 $K I2" DWP 12" CNI_ 36" CNIth8r <br /> ' General condition of wellhead assembly: Excellent oo Fair Poor <br /> PurgingEquipment: �� <br /> 2 disposable bailer Submersible pump <br /> `2" PVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> Sampled with: Disposable bailer: Teflon bailer: <br /> Well Diameter: 2n� 4" 6" $�+ <br /> rge Vol. Multiplier: 0.16 0.65 1.47 <br /> ' 2.61 gal/ft. <br /> "Time: t char a easurement <br /> Time:y_41 ^` Calculated <br /> Depth of well: /• /$ Depth to water: purge: <br /> Depth to water: Actual purge: <br /> Start purge:—tea. Sampling time: <br /> Time Temp. E.C. pH Turbidity Volume <br /> gzs 7/ 0 11 /o <br /> 11b1- 797 3 <br /> Sample appearance: Lock: <br /> Equipment replaced: (Check all that apply) Note condi <br /> Locking Cap: tion of replaced item <br /> 4" Locking Cap: Pock : 7/32 Allenhead: <br /> 6" Locking Cap: Lock-Dolphin: _ 9/16 Bolt! <br /> --�-- <br /> Pinned Allenhead (DWP) :---�� <br /> JeRemarks: --- <br /> I <br /> Signature: <br /> A <br /> 4 ! <br />
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