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WP2601479
Environmental Health - Public
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EHD Program Facility Records by Street Name
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SEIDNER
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4200/4300 - Liquid Waste/Water Well Permits
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WP2601479
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Entry Properties
Last modified
4/7/2026 7:43:11 AM
Creation date
3/11/2026 9:31:56 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP2601479
PE
4370 - WELL REPLACEMENT-Existing Well Not Viable
STREET_NUMBER
18672
Direction
S
STREET_NAME
SEIDNER
STREET_TYPE
AVE
City
ESCALON
Zip
95320
APN
22925036
CURRENT_STATUS
Closed - Complete
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
18672 S SEIDNER AVE ESCALON 95320
Tags
EHD - Public
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FGL Environmental Doc ID: 3D0900002_S0P_r4.dde <br /> Revision Date: 10/10/23 Page 1 of 1 <br /> Inter-Laboratory Con on Receipt (Attach to COC) �o,j� ID <br /> Sample Receipt at: CC CH VI <br /> 1. Number of ice chests/packages received: Shipping tracking#(s): <br /> 2. Temp IR Gun ID #:TH319 D <br /> 3. Were samples received on i ? Yes No Temps: <br /> Surface water SWTR bact samples: p e 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 <br /> 4. Do the number of bottles received agree with the COC? qO N/A <br /> 5. Were samples received intact? (i.e. no broken bottles, leaks etc.) Yes No <br /> 6. VOAs checked for Headspace? No N/A <br /> 7. Were all analyses within holding times at time of receipt? Ae No <br /> 8. Verify sample date, time and sampler name No <br /> Sign and date the COC,place in a ziplock and put iv <br /> ame ice chest as the samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: G 1. Number of ice chests/packages received: Shipping tracking#(s). � �2�"7.9 <br /> 2. Temp IR Gun ID #: I'M <br /> 3. Were samples received on ice? e No Temps: I 1 I I <br /> Acceptable is above freezing to 6°C. If m y packages are received at one time check for tests&1.T.'s/rushes/ <br /> 4. Do the number of bottles received agree with the COC? e 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 d print labels. <br /> Sample Verification,Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? No <br /> 2. Did bottle labels correspond with the client's ID's? ' No <br /> 3. Were all bottles requiring sample preservation properly preserved? No N/A FGL <br /> (Exception:Oil&Grease,VOA and CrVI verified in lab) <br /> 4. VOAs checked for Headspace? Yes No <br /> 5. Have rush or project due dates been checked and accepted? Ye No <br /> 6. Were all analyses within holding times at time of receipt? No <br /> Attach labels to the containers and include a copy of the COC for lab deliv <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: (3017919) <br /> Initiated By: San Joaquin Count EHD <br /> Problem: y <br /> Resolution: STU634210 <br /> iv 04101/202610:26:41 <br /> (Please use the back of this sheet for additional comme. III[[I[I[I[Iflf[![[[[I[I[[ia[[[[II�I re <br /> STK.2GSdPIA <br />
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