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ARCHIVED REPORTS_XR0008582
Environmental Health - Public
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EHD Program Facility Records by Street Name
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WATERLOO
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2537
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3500 - Local Oversight Program
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PR0545857
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ARCHIVED REPORTS_XR0008582
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Last modified
7/15/2020 4:57:43 PM
Creation date
7/15/2020 3:04:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008582
RECORD_ID
PR0545857
PE
3528
FACILITY_ID
FA0005147
FACILITY_NAME
E-Z FOOD
STREET_NUMBER
2537
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
11914035
CURRENT_STATUS
02
SITE_LOCATION
2537 WATERLOO RD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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LSauers
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EHD - Public
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SAMTL]NG INFORMATION SHEET �/l` c <br /> //'/ ta�vlw+Smer�faE <br /> oesultants,Enc. <br /> Sample ID# �� L Project Name: Project No <br /> ��oc�aaon {address) <br /> r <br /> ' Dam SaMpled: _a'L ! <br /> !W#9hea tXssembly comdiuon• GOO Fair Poor(If poor, See comments) <br /> Eqt i ent Replaced: bolts locks loclang cap <br /> e W Oepth 3 _ ft below top of caste Casing diameter incites <br /> itff to water(below top of casmg) Z- ft_ Date: <br /> _1_1_ Tune _ <br /> WelrCfi acing Volume Multiplier: 0.16 for 2", 0 65 for 4", 1.47 for 6" <br /> i `ftikffig method: Submersible pump Baer Centrifugal pump Other <br /> At least well volumes have been evacuated before sampling. <br /> Tubing(type: ._fir ). (new or previously used) was used to purge well <br /> Sampling method_ Disposable barer $ampUmg port <br /> Samples collected Sample appearance- <br /> Note <br /> ppearanceNote any samphng problems <br /> . GROUND WATER EVACUA'nON/STABII.MATION DATA <br /> Cumuiauve Volume of <br /> " w Conductance Water Level Water Removed from Well <br /> Time s Tem Tatum (°F) PH Units (umxtoslrm) (Nearest 0.01 R) (gallons) <br /> Y <br /> Commenw. <br /> Trnsportation(th=wd pieservatton) <br /> Form completed by: Sampled by: <br /> 5 <br />
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