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WP2501058
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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CAMPBELL
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17250
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4200/4300 - Liquid Waste/Water Well Permits
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WP2501058
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Entry Properties
Last modified
12/4/2025 8:24:00 AM
Creation date
10/8/2025 1:33:24 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP2501058
PE
4378 - WELL REPLACEMENT-Existing Well Viable
STREET_NUMBER
17250
STREET_NAME
CAMPBELL
STREET_TYPE
RD
City
ESCALON
Zip
95320
APN
22739003
CURRENT_STATUS
Closed
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
17250 CAMPBELL RD ESCALON 95320
Tags
EHD - Public
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ji <br /> FGL Environmental Doc ID:3D0900002 SOP 14.doc <br /> Revision Date: 10/10/23 Nge 1 of 1 <br /> Inter-Laboratory Condi ' on Receipt (Attach to C i ) <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. es o Tem s: q.I/ / <br /> P p <br /> Surface water SWTR bact samples: p e that has a temperature upon receipt of >10 C, ether i e' or not, <br /> should be flagged unless the time since sample collection has been less than two <br /> 4. Do the number of bottles received agree with the COC? N , / <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc.) Yes N <br /> 6. VOAs checked for Headspace? N6 <br /> 7. Were all analyses within holding times at time of receipt? AassExnpl <br /> N <br /> 8. Verify sample date,time and sampler name N <br /> Sign and date the COC,place in a ziplock and put in t e ice . it <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 is p <br /> . Y No Tem s: t <br /> Acceptable is above freezing to 6°C. I many packages are received atone time check for;esTrust s/ <br /> 4. Do the number of bottles received agree with the COC? te %5. Were samples received intact? (i.e. no broken bottles, leaks etc.) Ni <br /> Sign and date the COC, obtain LIMS sample numbers, select methods/tests and pri lab 111E. <br /> Sample Verification,Labeling and Distribution: f <br /> 1. Were all requested analyses understoodand acceptable? <br /> 2. Did bottle labels correspond with the clients ID's? l ! <br /> 3. Were all bottles requiring sample preservation properly preserved? es Nh FGL <br /> lException:Oil&Grease,VOA and CM verified in lab] <br /> 4. VOAs checked for Headspace? Yes / <br /> 5. Have rush or project due dates been checked and accepted? Ye <br /> 6. Were all analyses within holding times at time of receipt? Yes <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): Jlt')4 <br /> Discrepancy Documentation: JJ! <br /> Any items above which are "No" or do not meet specifications (i.e. temps)m t be I;eso VCd, <br /> 1. Person Contacted: Phone Number: I� <br /> Initiated By: Date: <br /> Problem: j <br /> Resolution: <br /> 2. Person Contacted: Phone Number: , <br /> Initiated By: Date: <br /> Problem: (3179 ) <br /> Resolution: I <br /> JoaqSan n <br /> (Please use the back of this sheet for additional comments or cont; ST i, 55 <br /> iv 10117 2025 4:2 01 <br /> *r X98 <br />
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