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WP0040785
Environmental Health - Public
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EHD Program Facility Records by Street Name
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12 (STATE ROUTE 12)
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040785
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Entry Properties
Last modified
11/19/2024 3:48:25 PM
Creation date
11/12/2021 10:07:51 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040785
PE
4366
STREET_NUMBER
26606
Direction
E
STREET_NAME
STATE ROUTE 12
City
CLEMENTS
Zip
95227-
APN
02322005
ENTERED_DATE
5/4/2020 12:00:00 AM
SITE_LOCATION
26606 E HWY 12
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2020
Tags
EHD - Public
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FGL Environmental Doc ID: 2D0900157_SOP_17-1.DOC <br /> Revision Date: 10/09/14 Page: 1 of 1 <br /> In-House Condition Up eipt (Attach to COC) cf/,1x/076 <br /> CC CH � VI SP <br /> Sample Recei t: <br /> 1. Number f ice chests/packages received: <br /> 2. Shipper I racking numbers <br /> G <br /> 3. Were s ples received in a chilled condition? Temps: <br /> 4. Surface 1 vater(S WTR) bact samples: A sample that has a temperature upon receipt of>I OOC, <br /> whether ced or not, should be flagged unless the time since sample collection has been less than <br /> two hou s. <br /> 5. Do then imber of bottles received agree with the COC? No N/A <br /> 6. Verify sample data,time, sampler 5No <br /> 7. Were samples received intact?(i.e. no broken bottles, leaks etc.) Yes No <br /> 8. Were sample custody seals intact? Yes No N/A <br /> Sample Verif cation, Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? Yes No <br /> 2. Did bottle labels correspond with the client's ID's? Yes No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No /A FGL <br /> [Exception:Oil&Grease,VOA and CM verified in labl <br /> 4. VOAs checked for Headspace? (YiD No N/A <br /> 5. Were all analyses within holding times at time of receipt? Yes No <br /> 6. Have rush or project due dates been checked and accepted? N/A Yes No <br /> Include a cop of the COC for lab delivery. (Bacti, Inorganics and Radio) <br /> Sample Receipt, Login and Verification completed by (initials): <br /> Discrepancy ocumentation: (attach additional pages if needed) <br /> Any items abc ve which are "No"or do not meet specifications (i.e. temps) must be resolved. <br /> 1. Person C ontacted: Phone Number: <br /> Initiated By: Date: <br /> Problem <br /> Resolution: <br /> 2. PersonContacted: Phone Number: <br /> Initiated By: Date: <br /> Problem <br /> Resoluti n: <br /> Attach label with lab number here <br /> [!sc this form vhcn all cont�imers are stavmL, in the lab and not being shippcd to FGL-SI' <br />
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