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WP0042885
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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99 (STATE ROUTE 99)
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18853
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042885
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Entry Properties
Last modified
11/19/2024 1:59:21 PM
Creation date
4/3/2023 2:59:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042885
PE
4366
STREET_NUMBER
18853
Direction
N
STREET_NAME
STATE ROUTE 99
City
ACAMPO
Zip
95220-
APN
01322062
ENTERED_DATE
1/10/2022 12:00:00 AM
SITE_LOCATION
18853 N HWY 99
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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FGL Environmental Doc ID:3D0900002_SOP_12.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter- ory Condition Upon Receipt (Attach to COC) 155wq <br /> 5e5 <br /> Sample Receipt at: STK CC / CH VI <br /> I. Number of ice chests/packages received: / Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps: 111-71 <br /> I I I <br /> Surface water SWTR bact samples:A sample 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 /> 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. o <br /> 5. VOAs checked for Headspace? es No <br /> 6. Were sample custody seals intact? Yes N <br /> 7. If required, was sample split for pH analysis? No <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date,time and sampler name s o <br /> Sign and date the COC,place in a ziplock and put in t e s e ice chest as the samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: I I I I <br /> Acceptable is above freezing to 60 C. Ian pack es are received at one time heck f r tests/ .T.'s/rushes/ <br /> : <br /> 2. Shipping tracking numbers <br /> u �Ilq G <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.) Cf:?� No -- <br /> _ <br /> 5. Were sample custody seals intact? Yes No C�.N/A� <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? Y � 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? s No N/A FGL <br /> lException:Oil&Grease,VOA and CM verified in labl <br /> 4. VOAs checked for Headspace? Yes No N/ <br /> 5. Have rush or project due dates been checked and accepted? Y No / <br /> 6. Were all analyses within holding times at time of receipt? Yes o <br /> Attach labels to the containers and include a copy of the COC fff <br /> ery. <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: (3017919) <br /> Initiated By: oa uin CountyEBB <br /> Problem: San J q <br /> Resolution: STC339055 <br /> 164 <br /> (Please use the back of this sheet for addii cda 03108/2023 07:05:53 er here <br /> contacts) 111111111111111111�11��i11111�111� <br /> STK2332955 <br />
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