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WP0043555
Environmental Health - Public
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4300 - Water Well Program
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WP0043555
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Entry Properties
Last modified
11/15/2022 2:26:56 PM
Creation date
8/17/2022 12:27:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0043555
PE
4366
STREET_NUMBER
22331
Direction
E
STREET_NAME
SKIFF
STREET_TYPE
RD
City
ESCALON
Zip
95320-
APN
20519003
ENTERED_DATE
7/29/2022 12:00:00 AM
SITE_LOCATION
22331 E SKIFF RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Tz019 E't�LE7720dd <br /> RSK Associates SR-FL-0002-23 <br /> Sample Integrity <br /> l`1 <br /> B_ SK Bottles. Yes N Page of ............................: <br /> Was temperature within ran Yes a NA Were correct containers and preservatives Yes No <br /> Chemist 5 6°C Micro<8°C received for the tests requested? <br /> %0- If samples were taken today,is there evidence Yes Na Bubbles Present VOAs(524.2TI THMTFCP)? Yes NA <br /> that chillinghas begun? TB Received? Check Method Below Yes o NA <br /> ODid all bottles arrive unbroken and intact? No Was a sufficient amount of sample received? es No <br /> U Did all bottle labels agree with COC? o Do samples have a hold time<72 hours' es <br /> Was sodium thiosulfate added to CN sample(s) Yes N Was PM notified of discrepancies? <br /> until chlorine was no longer present? PM: BylTime: Yes No <br /> 250m1(A)500mi(H) f!_rter(C)40mlVOA(V) 125ml(D) Checks, Passed? <br /> Bach Na2S203 — — <br /> None(p)White Cap — — <br /> Cr6(P)Lt.Green LabetSlue Cap NH40H(NH4R8O4 OW Ct,pH>8 P F <br /> Cr6(P) Pink LabeVt3lueCap NN40H(NH4)2SO4 WW pH 9.3-9.7 P F <br /> (�+�(P) 8"€.abellBlue Cap NH40H(NH4)2504 7199 <br /> c —24 HOUR HOLD TIMrE"" pH 9.0-9.5 P F <br /> EHNO3(P)P-d cap or HCI (P)purple ceplLl Blue Label — — <br /> qH2SO4 (P) or (AG) Y04-CaplLa4e€ PH<2 P F <br /> . NaOH (P)Grm. n Cap Cl, pH>10 P F <br /> CDCD <br /> NaOH +ZnAc(P) pH>9 P F <br /> 0 <br /> ¢ Dissolved Oxygen 300ml (g) — - <br /> - None(AG)sowawlmm,e2s,632t832i.8761.wo — — <br /> 4) <br /> HCI (AG)Lt.Blue Label O&G,Diesel,TCP — — <br /> m o <br /> m Ascorbic, EDTA, KH2Ct(AG)Plnk Label 525 — — <br /> a NazSO3 250mL(AG)N-n Green Label 515 — -- <br /> (A � <br /> U Na2S2031 Liter(Brown P)549 — — <br /> m <br /> c- Na2S203(AG)Blue Label 548.THM,524 — — <br /> `o <br /> a Na2S203(CG)B'-Lab6l 504,505,547 — — <br /> U <br /> o Na2S203+ IVICAA(CG)orangeLabel 931 pH < 3 P F <br /> m <br /> NH4CI (AG)PurpleLabel 5552 — — <br /> °' EDA(P) or (AG)Brcwn Label DBPs — — <br /> 62 HCL(CG)524.2,BTEX.Gas,MTBE.8260/624 — — <br /> Buffer pH 4 (CG.) — — <br /> H3PO4(CG)sat—Label — — <br /> _� Trizma-EPA 537.9 -Field Blank Required <br /> Other: <br /> Asbestos 1 L (P)wl Foil I LL Metals Bottle — — <br /> Bottled Water — <br /> Clear Glass — — <br /> Solids: Brass 1 Steel I Plastic Ba — — <br /> w Container Preservative Lot# Initials DatelTime Preservation 'Check <br /> L s P pH Lot# <br /> S P CI Lot# <br /> Tres�ervation check complete by I p perForr}�ing�alysis. ✓ Indicates Blanks Received <br /> J�� /���r�rt�p 604 524.2 — TTHM 537.1 TCP_ <br /> ✓ MSIMSO Received Method: <br /> Scanned: � Rush/Short HT Page: Timc <br /> Page8of9 <br />
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