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WP0042050
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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JACK TONE
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13012
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042050
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Entry Properties
Last modified
3/4/2026 2:45:58 PM
Creation date
2/10/2025 9:17:34 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042050
PE
4378 - WELL REPLACEMENT-Existing Well Viable
STREET_NUMBER
13012
Direction
N
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
LODI
Zip
95240-
APN
06502032
CURRENT_STATUS
Inactive
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
13012 N JACK TONE RD LODI 95240-
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 Condition pon Receipt (Attach to COQL�bfio�IP3`{ <br /> Sample Receipt at: CC CH VI <br /> 1. Number of ice chests/packages received: Shipping tracking#(s): <br /> 2. Temp IR Gun ID #:TH319 <br /> 3. Were samples received on ice? 'e No Temps: A( / <br /> Surface water SWTR bact samples: A sartiple that has a temperature upon receipt of >l0°C,whether iced or not, <br /> should be flagged unless the time since sample collet ion has been less than two hours. <br /> 4. Do the number of bottles received agree wit the COC? No N/A <br /> 5. Were samples received intact? (i.e. no broke bottles, leaks etc.) a No <br /> 6. VOAs checked for Headspace? No N/A <br /> 7. Were all analyses within holding times at ti nie of receipt? No <br /> 8. Verify sample date, time and sampler name es No <br /> Sign and date the COC, place in a ziplock and put ' the same 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): <br /> 2. Temp IR Gun ID#: !� <br /> 3. Were samples received on ice?� es No Temps: <br /> Acceptable is above freezing to 6°C. If repackage are received at one time check for tests/H.T.'s/rushes/ <br /> 4. Do the number of bottles received agree wit the COC? le <br /> No N/A <br /> 5. Were samples received intact? (i.e. no broke bottles, leaks etc.) No <br /> Sign and date the COC, obtain LIMS sample num ers, select methods/ted print labels. <br /> Sample Verification,Labeling and Distributio : <br /> 1. Were all requested analyses understood and cceptable? No <br /> 2. Did bottle labels correspond with the client' ID's? Yes No <br /> 3. Were all bottles requiring sample preservati n properly preserved? Yes No FGL <br /> lException:Oil&Grease, OA and CrVI verified in lab] <br /> 4. VOAs checked for Headspace? es No N/A <br /> 5. Have rush or project due dates been checke and accepted? Yes No <br /> 6. Were all analyses within holding times at tit a of receipt? r No <br /> Attach labels to the containers and include a copy of the COC for lab,deliwv� <br /> Sample Receipt, Login and Verification complete I by (initials): <br /> Discrepancy Documentation: <br /> Any items above which are "No" or do not meet pecifications (i.e. temps) must be resolved. <br /> 1. Person Contacted: Phone Number: <br /> Initiated By: Date: <br /> Problem: <br /> Resolution: <br /> 2. Person Contacted: (3017919) <br /> Initiated By: San Joaquin County EHI) <br /> Problem: <br /> Resolution: WHEN <br /> Indc 0212412026 16:13:39 <br /> (Please use the back of this sheet for additional commer Illllllllllllllllllulllllllllllllllllll <br />
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