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WP0041912
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041912
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Entry Properties
Last modified
12/19/2024 4:36:37 PM
Creation date
8/23/2022 4:49:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041912
PE
4366 - WELL DOMESTIC - </= 2 ACRE FT/YEAR
STREET_NUMBER
30667
Direction
S
STREET_NAME
KOSTER
STREET_TYPE
RD
City
TRACY
Zip
95304-
APN
25532011
CURRENT_STATUS
Inactive
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
30667 S KOSTER RD TRACY 95304-
Tags
EHD - Public
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FGL Environmental Doc ID: 3D0900002_SOP_14.DOC <br /> Revision Date: 10/10/23 Page 1 of 1 <br /> Inter-Laboratory Cond pon Receipt (Attach to COC) a4 55C <br /> Sample Receipt at: CC CH K VI ' <br /> 1. Number of ice chests/packages received: 1 Shipping tracking#(s): <br /> 2. Temp IR Gun ID #: �V- P1.1 l 1 <br /> 3. Were samples received on ice? Yes No Temps: <br /> Surface water SWTR bact samples: A samp a that has a temperature upon receipt of >10°C,whether iced or not, <br /> should be flagged unless the time since sample collection has been less than two hours. <br /> 4. Do the number of bottles received agree with the COC? No N/A <br /> 5. Were samples received intact? (i.e. no broken bottles, leaks etc.) es No <br /> 6. VOAs checked for Headspace? No /A <br /> 7. Were all analyses within holding times at time of receipt? *te <br /> No <br /> 8. Verify sample date, time and sampler name No <br /> Sign and date the COC, place in a ziplock and put in a same ice chesmples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Number of ice chests/packages received: �7 Shipping tracking #(s): <br /> 97q3 7W7 <br /> 2. Temp IR Gun ID #:i IfL j <br /> 3. Were samples received on ice? No Temps: �'L <br /> Acceptable is above freezing to 6°C. ifany packages are received at one time check for tests/H.T.'s/rushes/ <br /> 4. Do the number of bottles received agree with the COC? Ye No NIA <br /> 5. Were samples received intact? (i.e. no broken bottles, leaks etc.) )✓w No <br /> Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print labels. <br /> Sample Verification, Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? ffes No <br /> 2. Did bottle labels correspond with the client's ID's? Yes, No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No N/A FGL <br /> [Exception:Oil&Grease,VOA and CrVI verified in lab[ <br /> 4. VOAs checked for Headspace? Yes No <br /> 5. Have rush or project due dates been checked and accepted? Yes No tj 1 <br /> 6. Were all analyses within holding times at time of receipt? Ye No <br /> Attach labels to the containers and include a copy of the COC for lab delivery. <br /> Sample Receipt, Login and Verification completed by (initials): <br /> Discrepancy Documentation: <br /> Any items above which are"No" or do not meet specifications (i.e. temps) must be resolved. <br /> 1. Person Contacted: Phone Number: <br /> Initiated By: Date: <br /> Problem: <br /> Resolution: <br /> 2. Person Contacted: Phone Number: <br /> Initiated By: Date: <br /> Problem: — - <br /> Resolution: (3017919) <br /> San Joaquin County END <br /> (Please use the back of this sheet for additional comments or conta STUR35981 <br /> iv 04/3012024 15:57:46 <br /> Ill IllllKlllllllllilllll�lllllll Ill Ill <br /> srK2a3s9s1 <br />
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