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AP2501642
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4200/4300 - Liquid Waste/Water Well Permits
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AP2501642
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Entry Properties
Last modified
2/5/2026 4:36:57 PM
Creation date
7/10/2025 7:58:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
AP2501642
PE
4370 - WELL REPLACEMENT-Existing Well Not Viable
STREET_NUMBER
25931
Direction
E
STREET_NAME
MILLER
STREET_TYPE
AVE
City
ESCALON
Zip
95320
APN
22704002
CURRENT_STATUS
Closed - Issued
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
25931 E MILLER AVE ESCALON 95320
Tags
EHD - Public
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FGL Environmental Doc ID: 3DO900002_SOP_14.doc <br /> Revision Date: 10/10/23 Page I of 1 <br /> Inter-Laboratory Condition Upon Receipt (Attach to COC) 14 <br /> Sample Receipt at: CC CH TK VI <br /> 1. Number of ice chests/packages received: Shipping tracking #(s): <br /> 2. Temp IR Gun ID #:TH319 G <br /> 3. Were samples received on ice? 1es 0 Temps://- <br /> Surface water SWTR bact samples: A 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 COC? 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 <br /> 7. Were all analyses within holding times at time of receipt? es No <br /> 8. Verify sample date, time and sampler name , es No <br /> t e Sign and date the COC, place in a ziplock and put in le 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: —,2. Shipping tracking#(s)✓ 0� <br /> 1630 <br /> 2. Temp IR Gun ID #: 9(0 1 �3 <br /> 3. Were samples received on ice? I e� No Temps: / / / / <br /> Acceptable is above freezing to 6°C. If y packages are received atone time check for tests/H.T.'s/rushes/ <br /> 4. Do the number of bottles received agree with the COC? s No N/A <br /> 5. Were samples received intact? (i.e. no broken bottles, leaks etc.) ges 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? e No <br /> 2. Did bottle labels correspond with the client's ID's? Us No <br /> 3. Were all bottles requiring sample preservation properly preserved? tes No N/A FGL <br /> (Exception:Oil&Grease,VOA and CrVI verified in lab] <br /> 4. VOAs checked for Headspace? Yes No fA5. Have rush or project due dates been checked and accepted? Yes No <br /> 6. Were all analyses within holding times at time of receipt? ncs 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: <br /> Problem: (3017919) <br /> Resolution: San Joaquin County EHD <br /> STK2636636 <br /> (Please use the back of this sheet for additional comments or cone. iv 0111512026 07:31:18 <br /> III IIIII�IIIIIIIIIIIIIIIIIIIIIIII III <br />
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