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WP0043053
Environmental Health - Public
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EHD Program Facility Records by Street Name
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CARROLTON
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18163
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043053
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Entry Properties
Last modified
4/14/2026 8:37:55 AM
Creation date
6/10/2022 1:52:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043053
PE
4366 - WELL DOMESTIC - </= 2 ACRE FT/YEAR
STREET_NUMBER
18163
Direction
S
STREET_NAME
CARROLTON
STREET_TYPE
RD
City
RIPON
Zip
95366-
APN
24538026
CURRENT_STATUS
Inactive
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
18163 S CARROLTON RD RIPON 95366-
Tags
EHD - Public
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FGL Environmental Doc ID: 3D0900002_SOP_14.doc <br /> Revision Date: 10/10/23 Page 1 of 1 <br /> Inter-Laboratory Conditjetlp[)pon Receipt (Attach to COQ4699 VW <br /> Sample Receipt at: CC CH 1"T 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 No Temps: <br /> Surface water SWTR bact samples:A s 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.) Yes No <br /> 6. VOAs checked for Headspace? Yes 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 Yes No <br /> Sign and date the COC, place in a ziplock and put in the/s e ice chest as the samples. <br /> Sample Receipt Review completed by (initials): / <br /> Sample Receipt at SP:1. Number of ice chests/packages received: l^ <br /> i Shipping tracking #(s): <br /> o�S <br /> 2. Temp IR Gun ID #: -bttl(, <br /> 3. Were samples received on i e?� No Temps: /L / / <br /> Acceptable is above freezing to 6°C. If many packages are received at one time check for tests/H.T.'s/mshes/ <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 /> 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? fess <br /> No <br /> 3. Were all bottles requiring sample preservation properly preserved? No N/A FGL <br /> [Exception:Oil&Grease,VOA and CrVt verified in lab] <br /> 4. VOAs checked for Headspace? Yes No <br /> 5. Have rush or project due dates been checked and accepted? Yes 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 delie <br /> Sample Receipt, Login and Verification completed by (initials): K�L <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: n.fP- - - <br /> Problem: (3017919) <br /> Resolution: San Joaquin County NO <br /> (Please use the back of this sheet for additional comments or cor STU633934 <br /> mde 0312412026 16:52:35 <br /> 9iK26339N <br />
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