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WP0042721
EnvironmentalHealth
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DETERMINATION
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042721
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Entry Properties
Last modified
12/19/2024 3:44:12 PM
Creation date
8/25/2022 10:54:00 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042721
PE
4366 - WELL DOMESTIC - </= 2 ACRE FT/YEAR
STREET_NUMBER
31873
Direction
S
STREET_NAME
DETERMINATION
STREET_TYPE
DR
City
TRACY
Zip
95304-
APN
25534009
CURRENT_STATUS
Inactive
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
31873 S DETERMINATION DR 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 Condit"' A.IRon Receipt (Attach to COC) AL'507-6tC[q <br /> Sample Receipt at: CC CH VI <br /> 1. Number of ice chests/packages received: ( Shipping tracking#(s): <br /> 2. Temp IR Gun ID <br /> 3. Were samples received on ice? es >40 Temps: <br /> Surface water SWTR bact samples: A e 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 thantwo <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.) No <br /> 6. VOAs checked for Headspace? No N/A <br /> 7. Were all analyses within holding times at time of receipt? No <br /> 8. Verify sample date, time and sampler name Yes No <br /> Sign and date the COC, place in a ziplock and put in the Wine ice chest as the samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Number of ice chests/packages received: Shipping tracking#(s): WlI�j1J <br /> 2. Temp IR Gun ID#:" 9(113 <br /> 3. Were samples received on ice? 'e No Temps: IC / 1c / (Dc_ <br /> Acceptable is above freezing to 6°C. If many 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? No N/A <br /> ( <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc.) e 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? No <br /> 2. Did bottle labels correspond with the client's ID's? e No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No /A FGL <br /> lException:Oil&Grease,VOA and CM verified in labl <br /> 4. VOAs checked for Headspace? �es� No N/A <br /> 5. Have rush or project due dates been checked and accepted? Yes No /A <br /> 6. Were all analyses within holding times at time of receipt? & 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: - r'_. --- <br /> Problem: (3017919) <br /> Resolution: San Joaquin County END <br /> ST�436144 <br /> (Please use the back of this sheet for additional comments or iv 0510212024 08:20:45 <br /> 11111111 Rl I11V11111361111111111 Nl l� <br />
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