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AP2502124
EnvironmentalHealth
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ALPINE
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12190
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4200/4300 - Liquid Waste/Water Well Permits
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AP2502124
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Entry Properties
Last modified
1/28/2026 11:12:42 AM
Creation date
1/12/2026 10:37:35 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
AP2502124
PE
4366 - WELL DOMESTIC - </= 2 ACRE FT/YEAR
STREET_NUMBER
12190
Direction
N
STREET_NAME
ALPINE
STREET_TYPE
RD
City
LODI
Zip
95240
APN
06306027
CURRENT_STATUS
Closed - Issued
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
12190 N ALPINE RD LODI 95240
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 Condition U on Receipt (Attach to COC) 301 , <br /> Sample Receipt at: CC CH � VI <br /> 1. Number of ice chests/packages received: _J__ Shipping tracking #(s): <br /> 2. Temp IR Gun ID 4:TH319 ,� Q <br /> 3. Were samples received on ice? es No Temps: l Z <br /> Surface water SWTR bact samples:A s p e 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.) No <br /> 6. VOAs checked for Headspace? es No Z <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 an e s e ice chest as t e samples. <br /> Sample Receipt Review completed by (initials). <br /> Sample Receipt at SP: 2 11 <br /> 1. Number of ice chests/package eceived: 7 Shipping tracking #(s): SG�97�yy7 <br /> 2. Temp IR Gun ID #: C0� Y l S 37 <br /> 3. Were samples received on is Ye No Temps: /L <br /> Acceptable is above freezing to 6°C. I y 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? s No N/A <br /> 5. Were samples received intact? (i.e. no broken bottles, leaks etc.) Yes 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? No <br /> 2. Did bottle labels correspond with the client's ID's? No <br /> 3. Were all bottles requiring sample preservation properly preserved? 9YeS No N/A FGL <br /> [Exception:Oil&Grease,VOA and CM verified in labi <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? es 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):K� <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: (3017919) <br /> Resolution: San Joaquin County EHO <br /> (Please use the back of this sheet for additional comments or c STU636726 <br /> iv 01/16/2026 07:41:47 <br /> III IIIII�IIIIIIIIIIIIIIIIIIIIIIIII <br />
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