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AP2502240
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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AP2502240
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Entry Properties
Last modified
10/12/2026 7:43:53 AM
Creation date
9/30/2026 7:42:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
File Section
COMPLIANCE INFO
RECORD_ID
AP2502240
PE
4366 - WELL DOMESTIC - </= 2 ACRE FT/YEAR
STREET_NUMBER
11450
Direction
E
STREET_NAME
JAHANT
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
00718046
CURRENT_STATUS
Closed - Issued
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
11450 E JAHANT RD ACAMPO 95220
Tags
EHD - Public
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FGL Environmental Doc ID:2D2600009_SOP_15.DOC <br /> Revision Date: 08/18/26 Page 1 of 1 <br /> Inter-Laboratory Con 'V( Shipping <br /> on Receipt (Attach to COC)Sample Receipt at: CC CH VI <br /> 1. Number of ice chests/packages receive . tracking#(s): <br /> 2. Temp IR Gun ID#: TH319 C ection Factor: -0.2 <br /> 3. Were samples received on is Yes Corrected Temps: 1l r 7 <br /> Surface water SWTR bact samples: mp a 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 h <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? Y No /A <br /> 7. Were all analyses within holding times at time of receipt? No <br /> 8. Verify sample date,time and sampler name No <br /> 9. Custody Seals intact? Yes No NIA <br /> 10. Sample Receipt Review completed by(initials): <br /> Sample Receipt at SP: <br /> 1. Number of ice chests/packages received: Shipping tracking#(sf.5U*4<0-7 <br /> 2. Temp IR Gun ID#: Correction Factor: WZZ� 3792- <br /> 3. Were samples received on ice?Oany <br /> No Corrected Temps:I LmAA19Acceptable is above freezing to 6T. 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? Ee <br /> No N/A <br /> 5. Were samples received intact?(i.e. no broken bottles,leaks etc.) No <br /> 6. Custody Seals intact? Yes No <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? gess <br /> No <br /> 3. Were all bottles requiring sample preservation properly preserved? No N/A FGL* <br /> [Exception:Oil&Grease,VOA and CM verified In lab] *Samples preserved in lab <br /> 4. VOAs checked for Headspace? Yes No / <br /> 5. Have rush or project due dates been checked and accepted? Zes <br /> No A <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 b delivery. <br /> Sample Receipt, Login and Verification completed by (initials LA, <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: <br /> (3011919) <br /> Resolution: San Joaquin CountyEHO <br /> (Please use the back of this sheet for additional comma STK2654381 <br /> iv 09/23/2026 07:34:48 <br /> (II 1[I II[I[IIII[II[III[III[IIIIII I II[il <br /> STK2654781 <br />
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