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WP0040902
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040902
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Entry Properties
Last modified
12/19/2024 4:43:16 PM
Creation date
5/10/2024 9:07:15 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040902
PE
4366 - WELL DOMESTIC - </= 2 ACRE FT/YEAR
STREET_NUMBER
9206
STREET_NAME
LORRAINE
STREET_TYPE
RD
City
TRACY
Zip
95377-
APN
24806022
CURRENT_STATUS
Inactive
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
9206 LORRAINE RD TRACY 95377-
Tags
EHD - Public
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FGL Environmental Doc ID: 3D0900002_SOP_14.DOC <br /> Revision Date: 10/10/23 Page 1 of 1 <br /> Inter-Laboratory Conditio on Receipt (Attach to COQ44 %4_1 <br /> Sample Receipt at: CC CHVI <br /> 1. Number of ice chests/packages received. �Shipping tracking#(s): <br /> 2. Temp IR Gun ID #:_ ry 7 <br /> 3. Were samples received on ice? es o Temps: �� <br /> Surface water SWTR batt samples: A e 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 <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. Yes No <br /> 6. VOAs checked for Headspace? No N/A <br /> 7. Were all analyses within holding times at time of receipt? No <br /> 8. Verify sample date, time and sampler name Yes— No <br /> Sign and date the COC, place in a ziplock and put i he a ice cher a samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Number of ice chests/packages received: Shipping tracking#(s): 1�jrJ(QIcJJ <br /> 5(,vl�Cpj-F2"( <br /> 2. Temp IR Gun ID �juic-,S-74-14 <br /> 3. Were samples received on ice? Yes No Temps:_/SL/A_p�-�/ / <br /> Acceptable is above freezing to 6°C. If many 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? es No N/A <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc.) es 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? No <br /> 2. Did bottle labels correspond with the client's ID's? No <br /> 3. Were all bottles requiring sample preservation properly preserved? es No N/A FGL <br /> (Exception:Oil&Creast,VOA and CM verified in lab] <br /> 4. VOAs checked for Headspace? Yes No /A <br /> 5. Have rush or project due dates been checked and accepted? Yes No QLA, <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): yo i_ <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: (3017919) <br /> Resolution: San Joaquin County EHD <br /> STU436147 <br /> (Please use the back of this sheet for additional comments or cot iv 0510212024 08:20::56 <br /> H11111111111111111111111 <br /> STK2436147 <br />
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