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AP2400486
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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AP2400486
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Entry Properties
Last modified
5/21/2026 3:49:32 PM
Creation date
11/18/2024 3:43:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
AP2400486
PE
4370 - WELL REPLACEMENT-Existing Well Not Viable
STREET_NUMBER
23380
Direction
S
STREET_NAME
AUSTIN
STREET_TYPE
RD
City
RIPON
Zip
95366
CURRENT_STATUS
Pending
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
23380 S AUSTIN RD RIPON 95366
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 Condi ' on Receipt (Attach to COQ <br /> Sample Receipt at: CC CH K VI <br /> 1. Number of ice chests/packages receive : t Shipping tracking#(s): <br /> 2. Temp IR Gun ID#:TH319 g' <br /> 3. Were samples received on is Yes o Temps:_1 <br /> Surface water SWTR bact samples: 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 /> 4. Do the number of bottles received agree with the CM No N/A <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc.) es No <br /> 6. VOAs checked for Headspace? 4te <br /> 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 No <br /> Sign and date the COC,place in a ziplock and put i e sameye cheples. <br /> Sample Receipt Review completed by (initials): �V <br /> Sample Receipt at SP: <br /> 1. Number of ice chests/packages received: Shipping tracking#(s): SG <br /> 2. Temp IR Gun ID#: 74 <br /> �� SsG fob <br /> 3. Were samples received on ice? Oe 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? e 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? fes <br /> No <br /> 2. Did bottle labels correspond with the client's ID's? No <br /> 3. Were all bottles requiring sample preservation properly preserved? No N/A FGL <br /> [Exception:Oil&Grease,VOA and CrVI verified in lab] <br /> 4. VOAs checked for Headspace? Yes No <br /> 5. Have rush or project due dates been checked and accepted? Ye No /A <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 lad de�l�very. <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: <br /> Problem: (3017919) <br /> Resolution: San Joaquin CountyEND <br /> (Please use the back of this sheet for additional comments or c STK263693iv 05/14/2026 07:1656 <br /> EII E[IEIE41[E[IE�E�E[RIE[IfE[I[[I[II <br /> STVP636935 <br />
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