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WP0041718
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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MOORE
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16133
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4300 - Water Well Program
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WP0041718
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Entry Properties
Last modified
10/24/2022 2:36:12 PM
Creation date
9/30/2022 10:23:21 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0041718
PE
4366
STREET_NUMBER
16133
Direction
N
STREET_NAME
MOORE
STREET_TYPE
RD
City
LODI
Zip
95242-
APN
02702016
ENTERED_DATE
2/19/2021 12:00:00 AM
SITE_LOCATION
16133 N MOORE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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\1.-[1630 FGLEn2000 09/I4/2022 <br /> BSK Associates SR-FL-0002-23 <br /> lE) € <br /> Sample Integrity <br /> BSK Bottles: Yes N Page of _...- _...__......._.,...__._ ` <br /> Was temperature within ran Were correct con iners and preservatives <br /> NA <br /> Chemist 5 6°C Micro<80C Yes No NA received for the t sts requested? <br /> es o <br /> If samples were taken today, is there evidence Yes No &1 Bubbles Present OAs(524.2/17HMfTCP)? Yes N <br /> that chillinghas begun? TB Received? C eck Method Below Yes , N <br /> U Did all bottles arrive unbroken and intact? No Was a sufficient ount of sample received? No <br /> V Did ail bottle labels agree with COC? es Ne, Do samples have a hold time<72 hours? Yes <br /> Was sodium thiosuifate added to CN sampie(s) Was PM notified of discrepancies? <br /> until chlorine was no longer present? Yes PM: gyffime. Yes No <br /> 250mi(A)500ml(S) iLiter(C)40m1VOA(V) 125mf(D) Checks- Passed? <br /> Bactl Na2.S203 — — <br /> None(P)whitcCap — — <br /> Cr6(P)LI.Green LabelMue Cap NH40H(NH4)2So4 DIN Cl,pH>8 P F <br /> Cr6 (P) Pink LabelBlue Cap NH40H(NH4)2SO4 WW pH 9.3-9.7 P F <br /> Y Cr6(P) Bieck LabelfSNe Cap NH40H(NH4)2SO4 7199 <br /> c 1 —24 HOUR HOLD TIME— pH 9.0-9.5 P F <br /> EH NO3 (P)Red cap or HCI (P)Purple c-OP" Blue Label — <br /> `pt H2SO4 (P) or (AG) YWo-G pA-W pH<2 P F <br /> l NaOH (P)Greeff Cap Cl, pH>10 P F <br /> NaOH+ZnAC(P) pH>9 P F <br /> 0 <br /> Dissolved Oxygen 300ml(g) — — <br /> z <br /> None(AG)6081808118082.625.63218321,8151.8270 — — <br /> 0) as HCI (AG)LI.Blue Label O&G Diesel,TCP — <br /> a0i Ascorbic, EDTA, KH2Ct(AG)P'nk Label 525LL <br /> — — <br /> Na2SO3 250mi-(AG)Neon Green Label — <br /> Na2S2031 Liter(Brown P) 549 — — <br /> Vm- <br /> tn .� Na;2S203(AG)B€ue Label 548THM,524 — — <br /> UNazS2O3(CG)Blue Label 504,505,547 — — <br /> o Na2S203+ MCAA(CG)Grange Label 531 pH<3 P F <br /> m <br /> w NH4Ci(AG)P"'pla Label 552 -- — <br /> u, <br /> P EDA(P) or (AG) erwan Label DBPS — — <br /> 12 HCL (CG)524.2,BTEX,Gas,MTBE,8260/624 — — <br /> m <br /> E Buffer pH 4(CG) — <br /> =1 H3PO4(CG)sarnatLOW — — <br /> _ Trizma—EPA 537.1 -Field Blank Required <br /> Other: <br /> Asbestos 1 L (P)wl Foil 1 LL Metals Bottle — — <br /> Bottled Water — — <br /> Clear Glass — — <br /> Solids: Brass I Steel 1 Plastic Sag — — <br /> +, Container Preservative Lot# Initials DatelTi ne Preservation Check <br /> a S P pH Lot# <br /> S P CI Lot# <br /> 'Preservation check completed bylab performing analysis ✓ Indicates Blanks Received <br /> A0 qre, r„vf b�P i rtc �e-4� cv� Ssr►r(I�( <br /> 504 524.2 TTHM 537.1 TCP_ <br /> v ✓ MS/MSD Received Method: <br /> nn C' Rush/Short HT e: Time Pa <br /> Scanned:� g <br /> Page 8of9 <br />
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