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WP0044244
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0044244
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Entry Properties
Last modified
1/2/2025 7:58:46 AM
Creation date
10/9/2023 10:42:35 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0044244
PE
4378 - WELL REPLACEMENT-Existing Well Viable
STREET_NUMBER
20087
STREET_NAME
ELLIS
STREET_TYPE
RD
City
ESCALON
Zip
95320-
APN
24714021
CURRENT_STATUS
Inactive
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
20087 ELLIS RD ESCALON 95320-
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 /> �„�c2 e� <br /> Inter-Laboratory Conditio on Receipt (Attach to COC) <br /> Sample Receipt at: CC CH T VI ” <br /> 1. Number of ice chests/packages received: Shipping tracking#(s): <br /> 2. Temp IR Gun ID#: <br /> 3. Were samples received on ice? Yes No Temps`,` <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 /> 4. Do the number of bottles received agree with the COC? es No N/A <br /> 5. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> 6. VOAs checked for Headspace? 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 Ye No <br /> Sign and date the COC,place in a ziplock and put in th�'same ice chest as the samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Number of ice chests/packages received: IJ Shipping tracking#(s): <br /> #. '5 Co 0 63C)aCf__7G / 6-1 -7 <br /> 2. Temp IR Gun ID 2 �� <br /> 3. Were samples received on ice? & No Temps: <br /> Acceptable is above freezing to 6°C. If many 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? e No N/A <br /> W les received intact? i.e. no broken bottles leaks etc. V� No <br /> 5. Were samples ( } <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? es No <br /> 2. Did bottle labels correspond with the client's ID's? No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No 1 /t FGL <br /> [Exception:Oil&Grease,VOA and CM verified in lab[ <br /> 4. VOAs checked for Headspace? )Ce s No N/A <br /> 5. Have rush or project due dates been checked and accepted? Yes No LVA <br /> 6. Were all analyses within holding times at time of receipt? JCft 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): C <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: na*P• - <br /> Problem: (3017919) <br /> Resolution: San Joaquin CountyEHO <br /> (Please use the back of this sheet for additional comments or conta STu""356120 <br /> iv 11/21/2023 08:05:18 <br /> �I I�Il 11 Ill��llll�lllllal11111I� <br /> STV2356120 <br />
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