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WP0043542
EnvironmentalHealth
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MICKE GROVE
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043542
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Entry Properties
Last modified
6/26/2024 11:12:27 AM
Creation date
6/5/2024 2:20:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043542
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 Condi ' on Receipt (Attach to COC} ✓/7� <br /> Sample Receipt at: CC CH K VI <br /> 1. Number of ice chests/packages receive Shipping tracking#(s): <br /> 2. Temp IR Gun ID#: <br /> 3. Were samples received on is Yes o Temps: I l <br /> i,/ <br /> Surface water SWTR bact samples: p 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 two s. <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 et Ye No <br /> 6. VOAs checked for Headspace? Aase <br /> 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 in a same ice cples. <br /> Sample Receipt Review completed by (initials): 6W <br /> Sample Receipt at SP: <br /> 1. Number of ice chests/packages received: Shipping tracking#(s): >G lq(o <br /> 2. Temp IR Gun ID#: -FP Z-U <br /> 3. Were samples received on ice? Ye No Temps: �� <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? QLesNo N/A <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc.) Yr.% 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? QCSs, No <br /> 2. Did bottle labels correspond with the client's ID's? Yr.V No <br /> 3. Were all bottles requiring sample preservation properly preserved? Y s No N/A FGL <br /> (Exception:Oil&Grease,VOA and CM verified in labl <br /> 4. VOAs checked for Headspace? Yes No kWA <br /> 5. Have rush or project due dates been checked and accepted? Yes NoTSA/ <br /> 6. Were all analyses within holding times at time of receipt? ` W 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): <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 CountyEHD <br /> (Please use the back of this sheet for additional comments or conta( ST9437400 <br /> cda 0512312024 09:05:45 <br /> Ili�l 11�111�1�1Ii1Ill�lllllll I rel <br /> crv�e'[�eaa <br />
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