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WP0045290
Environmental Health - Public
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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 Condit' pon Receipt (Attach to COC) *'L5167!95 <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#: j <br /> 3. Were samples received on i Yes No Temps: I I• / / / / <br /> Surface water SWTR bact samples. a that has a temperature upon receipt of >101 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? Aast <br /> No A <br /> 7. Were all analyses within holding times at time of receipt? No <br /> 8. Verify sample date,time and sampler name No <br /> Sign and date the COC,place in a ziplock and put inV�ce ples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: y <br /> 1. Number of ice chests/packages received: Shipping tracking#(s): �� o <br /> 2. Temp IR Gun ID#: U, <br /> 3. Were samples received on ice? Ye No Temps: 2' <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? LYee No N/A <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc.) tgs/ 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? Yes No <br /> 2. Did bottle labels correspond with the client's ID's? ese / No <br /> 3. Were all bottles requiring sample preservation properly preserved? Y No N/A FGL <br /> [Exception:Oil&Grease,VOA and CrVI verified in lab) <br /> 4. VOAs checked for Headspace? Yes No VVA,� <br /> 5. Have rush or project due dates been checked and accepted? Yes No NW <br /> 6. Were all analyses within holding times at time of receipt? 8Ye 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): I�- <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: (3017919) <br /> Resolution: <br /> San Joaquin CountyEHD <br /> (Please use the back of this sheet for additional comments or cont; STK2451925 <br /> jaw 081131202416:44:00 <br /> �l I���lalDll11111�111fD1111n1� <br /> STK2431925 <br />
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