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WP0043666
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FOREST LAKE
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4300 - Water Well Program
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WP0043666
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Entry Properties
Last modified
11/15/2022 2:34:24 PM
Creation date
11/15/2022 2:16:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0043666
PE
4370
STREET_NUMBER
3522
Direction
E
STREET_NAME
FOREST LAKE
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
00514123
ENTERED_DATE
8/23/2022 12:00:00 AM
SITE_LOCATION
3522 E FOREST LAKE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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4J't101- 112022 1 <br /> BSK Associates SR-FL-0002-23 <br /> IO <br /> Sample Integrity <br /> BSK Bottles: Yes (N�) Page of <br /> Was temperature within range? es No NA Werecorrect containers and preservatives Yes to NA <br /> Chemist 5 WC Micro<80C received for the tests requested? <br /> 12 If samples were taken today, is there evidence Bubbles Present VOAs(524.2/TTHM/TCP)? Yes No <br /> that chilling has begun? Yes No TB Received? Check Method Below Yes No6A <br /> U Did all bottles arrive unbroken and intact? No Was a sufficient amount of sample received? s - No <br /> Did all bottle labels agree with COC? es No Do samples have a hold time X72 hours? Yes <br /> Was sodium thiosulfale added to CN sample(s) YesWas PM notified of discrepancies? Yes No <br /> until chlorine was no longer present? PM: BylTime: <br /> 250ml(A)500mlfB) 1Liter(C)40mlVOA(V) 125ml(D) Checks' Passed? <br /> Bacti Na2S203 — — <br /> None(P)WhiteCap — — <br /> Cr6 (P)Lt.Green Labeflalue Cap NH40H(NH4)2S44 DW Cl, pH>8 P F <br /> Cr6 (P) Pink LabelBlue Cap NH40H(NH4)2S44 WW pH 9.3-9.7 P F <br /> Y Cr6 P Black LabevBlue Cap NH40H(NH4)2504 7199 <br /> ( ) pH 9.0-9.5 P F <br /> � "'24 YOUR BOLD 77ME"' <br /> HNO3 (P)Redcap or HCl (P) Parpfe CaplLl.alas Label — — <br /> H2SO4 (P) or (AG) Yellow Cap/Label pH<2 P F <br /> in <br /> NaOH (P)Green Cap Cl, pH X10 P F <br /> NaOH t ZnAc(P) pH>9 P F <br /> o <br /> ¢ Dissolved Oxygen 300ml (g) — — <br /> z <br /> -o None(AG)60818081/8082,625,632!8321,8151,8270 — <br /> ? HCI (AG)Lt.Blue Label O&G,Diesel,TCP — — <br /> Ascorbic, EDTA, KH2Ct(AG)Pink Label — <br /> v Na2SO3 250mL (AG)N-n Green Labet 515 — — <br /> L) Na2SZO31 Liter(Brown P) 549 — -- M U <br /> 0in m Na2S203(AG)Blue Labe! 548THM,524 — — <br /> `o <br /> U Na2S203(CG)Blue Label 504,505,547 — <br /> o Na2S203+ MCAA(CG)Orange Label 531 pH<3 P F <br /> NH40(AG)Purple Label 552 — — <br /> a' EDA(P) or (AG) 1310-n Label DBPs — <br /> c HCL (CG) 524.2,BTEx,Gas,MTBE,82601624 — — <br /> m <br /> E Buffer pH 4 (CG) — — <br /> H3PO4(CG)Sanon Label — — <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 W 1 VC)pz — — <br /> Solids: Brass / Steel 1 Plastic Bag — <br /> ,_, Container Preservative Lot# Initials Date/Time Preservation Check <br /> S P pH Lot# <br /> S P Cl Lot# <br /> *Preservation check completed by lab performing analysis. ✓ Indicates Blanks Received <br /> 504_ 524.2! TTH M_ 537.1 _ TCP_ <br /> E <br /> ✓ MSIMSD Received Method: <br /> Scanned: LT Rush/Short HT Page: Time: <br /> Page 8 of 9 <br />
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