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WP0042523
Environmental Health - Public
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EHD Program Facility Records by Street Name
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HARNEY
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15515
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042523
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Entry Properties
Last modified
5/2/2023 4:27:43 PM
Creation date
12/21/2022 9:39:19 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042523
PE
4380
STREET_NUMBER
15515
Direction
E
STREET_NAME
HARNEY
STREET_TYPE
LN
City
LODI
Zip
95240-
APN
05309007
ENTERED_DATE
9/9/2021 12:00:00 AM
SITE_LOCATION
15515 E HARNEY LN
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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YUL Environmental Doc ID:3DO900002 SOP 12.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-L tory Condition Upon Receipt (Attach to COC) 4z 'goo <br /> Sample Receipt at: STK CC CH VI <br /> 1. Number of ice ches s packages received: / Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps: 4 • 9- / <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 /> 3. Do the number of bottles received agree with the COC? No N/A <br /> 4. Were samples received intact?(i.e. no broken bottles, leaks etc.) Yes No <br /> .5. VOAs checked for Headspace? es No <br /> 6. Were sample custody seals intact? Yes N <br /> P Y o <br /> 7. If required, was sample split for pH analysis? No N/A <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date, time and sampler name Yes No <br /> Sign and date the COC,place in a ziplock and put in th a ice chest as the samples. <br /> Sample Receipt Review completed by(initials): <br /> Sample Receipt at SP: <br /> I. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 60 C. if many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: <br /> 3. Do the number of bottles received agree with the COC? Yes No N/A <br /> 4. Were samples received intact?(i.e. no broken bottles, leaks etc.) Yes No <br /> 5. Were sample custody seals intact? Yes No N/A <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? 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 N/A FGL <br /> (Exception:Oil&Crease.VOA and CrVI verified in labl <br /> 4. VOAs checked for Headspace? Yes No N/A <br /> 5. Have rush or project due dates been checked and accepted? Yes No N/A <br /> 6. Were all analyses within holding times at time of receipt? Yes 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): <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 /> Resolution: <br /> (Please use the back of this sheet for additional comments or Attach label with Iab number here <br /> contacts) <br />
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