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WP0044687 (2)
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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4200/4300 - Liquid Waste/Water Well Permits
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WP0044687 (2)
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Entry Properties
Last modified
5/21/2026 12:20:20 PM
Creation date
4/27/2026 9:49:19 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
File Section
COMPLIANCE INFO
RECORD_ID
WP0044687
PE
4378 - WELL REPLACEMENT-Existing Well Viable
STREET_NUMBER
15770
Direction
E
STREET_NAME
RIVER
STREET_TYPE
RD
City
RIPON
Zip
95366-
APN
24518009
CURRENT_STATUS
Active
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
15770 E RIVER RD RIPON 95366-
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 Condit' on Receipt (Attach to COC) L3/ P <br /> Sample Receipt at: CC CH STK VI <br /> 1. Number of ice chests/packages rece ve Shipping tracking#(s): <br /> 2. Temp IR Gun ID #:TH319 <br /> 3. Were samples received on ice? Yes No Temps: <br /> P p _� <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? No N/A <br /> 5. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> 6. VOAs checked for Headspace? e No N/A <br /> 7. Were all analyses within holding times at time of receipt? No <br /> 8. Verify sample date, time and sampler name a No <br /> Sign and date the COC,place in a ziplock and put in the same ice chest as the samples. <br /> Sample Receipt Review completed by(initials): Q19 / <br /> Sample Receipt at SP: <br /> 1. Number of ice chests/packages received: Shipping tracking#(s): <br /> 2. Temp IR Gun ID #: a G Cf l D <br /> �� �� <br /> 3. Were samples received on ice? Qn)yyipackages <br /> No Temps: I I I I <br /> Acceptable is above freezing to 6°C. if 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.) 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? es No <br /> 2. Did bottle labels correspond with the client's ID's? No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No JN1FGL <br /> [Exception:Oil&Grease,VOA and CM verified in lab) <br /> 4. VOAs checked for Headspace? (YYgs No N/ <br /> 5. Have rush or project due dates been checked and accepted? Ye No / <br /> 6. Were all analyses within holding times at time of receipt? 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): W, lam <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: <br /> San Joaquin CountyEHD <br /> (Please use the back of this sheet for additional comments or STK2636376 <br /> iv 05105/202616:15:54 <br /> STV:2636376 <br />
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