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WP0045027
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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120 (STATE ROUTE 120)
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22392
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4200/4300 - Liquid Waste/Water Well Permits
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WP0045027
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Entry Properties
Last modified
11/19/2024 4:01:51 PM
Creation date
1/31/2024 3:16:11 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0045027
PE
4370
STREET_NUMBER
22392
Direction
E
STREET_NAME
STATE ROUTE 120
City
ESCALON
Zip
95320-
APN
24509017
ENTERED_DATE
11/6/2023 12:00:00 AM
SITE_LOCATION
22392 E HWY 120
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\gmartinez
Tags
EHD - Public
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FGL Environmental Doc ID:3DO900002 SOP 14.DOC <br /> Revision Date: 10/10/23 Page 1 of 1 / , <br /> Inter-Laboratory Conditi ", pon Receipt (Attach to COC) `�ISample Receipt at: CC CH TVI <br /> 1. Number of ice chests/packages received:SShipping tracking#(s): <br /> 2. Temp IR Gun ID <br /> 3. Were samples received on ice? Y° No Tempsf <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 ho <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? s No <br /> 7. Were all analyses within holding times at time of receipt? No <br /> 8. Verify sample date, time and sampler name No <br /> Sign and date the COC, place in a ziplock and put in t same 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: 2' Shipping tracking#(s): <br /> 2. Temp IR Gun ID #: -04T(o3 7-3 I <br /> 3. Were samples received on ice? /De No Temps: (C / <br /> Acceptable is above freezing to 6°C. If r 'iy 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? ke,9 No N/A <br /> 5. Were samples received intact? (i.e. no broken bottles, leaks etc.) Yy ' 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? LYrw No <br /> 2. Did bottle labels correspond with the client's ID's? lXg,s No <br /> 3. Were all bottles requiring sample preservation properly preserved? kYev No N/A FGL <br /> (Exception: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? Yes No ice/ r <br /> 6. Were all analyses within holding times at time of receipt? Yes 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): Mac <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: Date: <br /> Problem: (3017919) <br /> Resolution: <br /> San Joaquin County EHD <br /> (Please use the back of this sheet for additional comments or conta STUR35794 <br /> iv 0412612024 07:37:38 <br /> III laall <br /> STK( 435 <br /> 2 <br /> STI IIIfIaIlflUi�l <br /> 435794 _ __ <br />
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