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WP0041919
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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4300 - Water Well Program
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WP0041919
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Entry Properties
Last modified
9/16/2022 11:33:39 AM
Creation date
9/8/2022 4:48:57 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0041919
PE
4366
STREET_NUMBER
26263
Direction
E
STREET_NAME
DOVE
STREET_TYPE
RD
City
ESCALON
Zip
95320-
APN
20720032
ENTERED_DATE
4/9/2021 12:00:00 AM
SITE_LOCATION
26263 E DOVE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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Tags
EHD - Public
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FGL Environmental Doc ID:3DO900002_SOP_12.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter- torY Condition Upon Receipt Attach to COC) <br /> Sample Receipt at: STK CC CH VI <br /> 1. Number of ice c ackages received: Ship7w/ <br /> g tracking# <br /> P <br /> 2. Were samples received in a chilled condition? Temps: <br /> Surface water SWTR bact samples:A sample that has a temperature upon receipt of >100 C,whether iced or not, <br /> should be flagged unless the time since sample collection has been less than two hours. <br /> 3. Do the number of bottles received agree with the COC? o N/A <br /> 4. Were samples received intact?(i.e. no broken bottles, leaks etc.) Yes- o <br /> 5. V OAs checked for Headspace? Yes No <br /> 6. Were sample custody seals intact? Yes No <br /> 7. If required, was sample split for pH analysis? No A <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date,time and sampler name Yes No <br /> Sign and date the COC,place in a ziplock and put i e ice chest as ples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 60 C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: <br /> ss`�sc� <br /> cru f s�� <br /> 3. Do the number of bottles received agree with the COC? No N/A <br /> 4. Were samples received intact?(i.e. no broken bottles, leaks etc.) fe No <br /> 5. Were sample custody seals intact? Yes No G <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? No <br /> 3. Were all bottles requiring sample preservation properly preserved? No N/A FGL <br /> ]Exception:Oil&Grease,VOA and CrV[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 / <br /> 6. Were all analyses within holding times at time of receipt? es 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). CD4 <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 /> (3017919) <br /> 2. Person Contacted: San Joaquin County END <br /> Initiated By: <br /> Y <br /> Problem: STU250946 <br /> Resolution: <br /> iv 08104/2022 06:08:36 <br /> (Please use the back of this sheet for additional cot 11111111111111111111111111111101111 <br /> contacts) STK2250940 <br />
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