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WP0043537
EnvironmentalHealth
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MICKE GROVE
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043537
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Entry Properties
Last modified
6/26/2024 11:12:26 AM
Creation date
6/5/2024 2:19:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043537
PE
4366
STREET_NUMBER
11250
Direction
N
STREET_NAME
MICKE GROVE
STREET_TYPE
RD
City
LODI
Zip
95240-
APN
05914069
ENTERED_DATE
7/27/2022 12:00:00 AM
SITE_LOCATION
11250 N MICKE GROVE RD
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 CondiF: 11 <br /> n Receipt (Attach to COC) <br /> Sample Receipt at: CC CH VI <br /> 1. Number of ice chests/packages receive Shipping tracking#(s): ' <br /> 2. Temp IR Gun ID #: <br /> 3. Were samples received on ice Yes o Temps:/ <br /> Surface water SWTR bact samples: that has a temperature upon receipt of >l01 C,whether iced or not, <br /> should be flagged unless the time since sample collection has been less than two hours. <br /> 4. Do the number of bottles received agree with the COC? Ite <br /> No N/A <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etcNo <br /> 6. VOAs checked for Headspace? o N/A <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 i ame ice chples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Number of ice chests/packages received: Shipping tracking#(s): S(0/'4 b-Z. b 6 <br /> 2. Temp IR Gun ID #: -E"L'A <br /> 3. Were samples received on ice? Ye No Temps: )L <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? � No N/A <br /> 5. Were samples received intact? (i.e. no broken bottles, leaks etc.) Yes 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? Ves. No <br /> 2. Did bottle labels correspond with the client's ID's? Ves No <br /> 3. Were all bottles requiring sample preservation properly preserved? OCesl No N/A FGL <br /> [Exception:Oil&Grease,VOA and CM verified in labl <br /> 4. VOAs checked for Headspace? Yes No 61LA� <br /> 5. Have rush or project due dates been checked and accepted? Yes No Alm <br /> 6. Were all analyses within holding times at time of receipt? Ye No <br /> Attach labels to the containers and include a copy of the COC for lab delive <br /> Sample Receipt, Login and Verification completed by (initials): %-/'Of, <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: <br /> Resolution: (3017919) <br /> San Joaquin CountyEND <br /> (Please use the back of this sheet for additional comments or coy STK2437397 <br /> cda 05/23/2024 09:05:38 <br /> Il!11111�1111�f�111111111��1111111111 <br /> CTV9AT7Tp' <br />
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