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WP0045290
Environmental Health - Public
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EHD Program Facility Records by Street Name
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SANTA CRUZ
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4200/4300 - Liquid Waste/Water Well Permits
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WP0045290
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Entry Properties
Last modified
12/23/2024 1:21:10 PM
Creation date
5/16/2024 11:04:36 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0045290
PE
4366 - WELL DOMESTIC - </= 2 ACRE FT/YEAR
STREET_NUMBER
450
Direction
N
STREET_NAME
SANTA CRUZ
STREET_TYPE
CT
City
LINDEN
Zip
95236-
APN
09303076
CURRENT_STATUS
Inactive
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
450 N SANTA CRUZ CT LINDEN 95236-
Tags
EHD - Public
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FGL Environmental Doc ID: 3DO900002_SOP_14.DOC <br /> Revision Date: 10/10/23 Page 1 of 1 <br /> Inter-Laboratory Cond' ' on Receipt (Attach to COC} I JA <br /> Sample Receipt at: CC CH STK VI <br /> 1. Number of ice chests/packages received: _I Shipping tracking#(s): <br /> 2. Temp IR Gun ID #: f� /III <br /> 3. Were samples received on ice? Yes No Temps: <br /> Surface water SWTR bact samples:A samp a 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 tw <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. No <br /> 6. VOAs checked for Headspace? s 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 i e same 'ce chest as the samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: I N I p <br /> 1. Number of ice chests/packages received: Shipping tracking#(s): 5 <br /> 1-7 ov 1,330 <br /> 2. Temp IR Gun ID#: l• <br /> 3. Were samples received on ice? Oe 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/rushes/ <br /> 4. Do the number of bottles received agree with the COC? XesA No N/A <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc.) ( 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? LYep No <br /> 2. Did bottle labels correspond with the client's ID's? Y9 No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No EAFGL <br /> [Exception:Oil&Grease,VOA and CM verified in lab[ <br /> 4. VOAs checked for Headspace? Yes No N/ <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? 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):J&,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: Date: <br /> Problem: - - -- - - <br /> Resolution: (3017919) <br /> San boa uin County <br /> q END <br /> (Please use the back of this sheet for additional comments or cont ST12451926 <br /> jaw 081131202416:43:48 <br /> 11110 111111111111111111 <br /> STK24 <br /> 31926 <br />
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