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ARCHIVED REPORTS_XR0008843
Environmental Health - Public
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WATERLOO
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2900 - Site Mitigation Program
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PR0543607
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ARCHIVED REPORTS_XR0008843
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Last modified
10/10/2020 10:36:39 PM
Creation date
7/9/2020 10:18:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008843
RECORD_ID
PR0543607
PE
3528
FACILITY_ID
FA0006343
FACILITY_NAME
STOCKTON MOBIL 3*
STREET_NUMBER
2358
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
14118221
CURRENT_STATUS
02
SITE_LOCATION
2358 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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DOULOS ENVIRONMENTAL _ JMPANY <br /> SAM ING INFORMATION SHEET <br /> Client: <br /> Sampling Date: <br /> Site; Project No. : 94-419-0 <br /> 2250 Wa&erlog R2ad Well Designation: MW- <br /> Stockton, C <br /> time: hours , <br />,s setup of traffic control devicesrequired? YES pmeTOC Helow TQC <br /> Cs there standing water in well box.' <br /> ut level? NO 'VU if no, see remarks <br />[s top of casing cNO If no, see remarks <br /> Cs well cap sealed and locked? <br /> ieight of well casing riser (in 1 n .__ _.._ <br /> c a )_ " 12" EMC her <br /> $" BK <br /> dell cover type: 8" W—�-�-- n CNx^� 36 CNI� <br /> L2" BK� 12" DWP <br />;eneral condition of wellhead assembly: Excellent Goo Fair Poor <br /> 2" disposable bailer ^submersible pump <br /> 3,urging Equipment: 2" pVC bailer Dedicated bailer <br /> 4" PVC bailer Centrifugal pump <br /> 11 <br /> Teflon bailer: <br /> Sampled with: Disposable bailer: <br /> Well Diameter: 2"� 4" 6"� an <br /> 0. 65 1.47 2 . 61 gal/ft. <br /> loge Vol. Multiplier: 0. 16 'Rgrha ea ea u e e <br /> rnit s e e <br /> Time:. - �� Calculated purge: 9 1� <br /> time: -)-2- •' <br /> Depth of well: Depth to water:_ Z Actual purge: <br /> Depth to water: <br /> Start purge• l�1 Sampling time: 30 <br /> 0 — <br /> • <br /> Time Temp. <br /> E.C. pH Turbidity Volume <br /> 7z4-1 � 1 <br /> 316 Wo 3 <br /> 3 '< -7 �, �� y� �z� 4 <br /> Sample appearance: o-"- Lock: <br /> Equipment replaced: (Check all that apply) Note condition of replaced item <br /> 2" Locking Ca Lock 03753 : 7/32 Allenhead:___ . <br /> 4" Locking Cap:. Lock-Dolphin: ,�— 9/16 Bolt:---. <br /> 11 Locking Cap:_ Pinned Allenhead (DWP) :16 <br /> �.— <br /> Remarks: <br /> Signature: <br />
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