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AP2401108
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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AP2401108
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Entry Properties
Last modified
1/9/2025 3:00:31 PM
Creation date
11/22/2024 11:36:26 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
AP2401108
PE
4370 - WELL REPLACEMENT-Existing Well Not Viable
STREET_NUMBER
11425
Direction
E
STREET_NAME
BENNDORF
STREET_TYPE
RD
City
ACAMPO
Zip
95220
CURRENT_STATUS
Closed - Issued
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
11425 E BENNDORF RD ACAMPO 95220
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 Conditio Upon Receipt (Attach to COC) 19Z <br /> Sample Receipt at: CC CHST VI <br /> 1. Number of ice chests/packages received: Shipping tracking#(s): ' <br /> 2. Temp IR Gun ID#: <br /> Y <br /> 3. Were samples receiv d n ice? 6-.-DsNo Temps: <br /> Surface water SWTR bact samples:A sample that has a temperature upon receipt of >I 0°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? es No N/A <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc.) Yes No <br /> 6. VOAs checked for Headspace? Yes No N/ <br /> 7. Were all analyses within holding times at time of receipt? No <br /> 8. Verify sample date,time and sampler name YO No <br /> Sign and date the COC,place in a ziplock and put in&e*e 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: Shipping tracking#(s): "5&2,:2,7--302- <br /> 2. <br /> 7&ZZv3022. Temp IR Gun ID#: 714UP <br /> �C <br /> 3. Were samples received on ice? �Y�s No s:Tem <br /> p 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? No N/A <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc.) Y 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? W29P 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 CM verified in lab] <br /> 4. VOAs checked for Headspace? Yes No / <br /> 5. Have rush or project due dates been checked and accepted? Yes No N/ <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 deliv <br /> Sample Receipt, Login and Verification completed by (initials): 1'�L <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 cc STU456432 <br /> iv 11/06/2024 08:01:17 <br /> Ill Ill II Il llllllllllllllllllllllllll III <br /> STK2496432 <br />
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