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WP0038825
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CLOUGH
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4200/4300 - Liquid Waste/Water Well Permits
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WP0038825
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Entry Properties
Last modified
12/27/2021 3:37:51 PM
Creation date
11/28/2018 9:51:41 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0038825
PE
4378
STREET_NUMBER
24803
Direction
E
STREET_NAME
CLOUGH
STREET_TYPE
AVE
City
ESCALON
Zip
95320-
APN
24714025
ENTERED_DATE
10/1/2018 12:00:00 AM
SITE_LOCATION
24803 E CLOUGH AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2018
Tags
EHD - Public
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FGL Environmental <br />Revision Date: 10/09/14 <br />Doc ID: 3DO900002_SOP_ <br />Page 1 of I <br />Inter -Laboratory Condition Upon Receipt (Attach to COC) <br />Sample Receipt at: CC CH VI <br />1. Number of ice chests/packages received: Shipping tracking # <br />2. Were samples received in a chilled condition? Temps: 11.2-/ / / _ <br />Surface water SWTR bact samples: A sample that has a temperature upon receipt of ;-1-0'C, wheth <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 <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) a No <br />5. VOAs checked for Headspace? s No <br />6. Were sample custody seals intact? �-No I <br />7. If required, was sample split for pH analysis? eY s No <br />8. Were all analyses within holding times at time of receipt?sus No <br />9. Verify sample date, time and sampler nameC yY�s No <br />Sign and date the COC, place in a ziplock and pu t s e ice chest as the samples. <br />Sample Receipt Review completed by (initials): jTtc9rJ� f3�s <br />Sample Receipt at SP: <br />PstiZ 1��c <br />1. Were samples received in a chilled condition? Temps: <br />Acceptable is above freezing to 60 C. if many pack es are received at one time chec fortests/H.T.'s/ru: <br />2. Shipping tracking numbers: y 3„_/ � -7Z91 <br />3. Do the num er of bottles received ee with the COC? No <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br />5. Were sample custody seals intact? es No < <br />Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print labs <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? Yes No <br />3. Were all bottles requiring sample preservation properly preserved? Yes No <br />(Exception: Oil & Grease, VOA and CrVI verified in labl <br />4. VOAs checked for Headspace? es` No <br />5. Have rush or project due dates been checked and accepted? Yes No C <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 ab ry. <br />Sample Receipt, Login and Verification completed by (initia s): <br />Discrepancy Documentation: <br />Any items above which are "No" or do not meet specifications (i.e. temps) must be resol <br />1. Person Contacted: Phone Number: <br />Initiated By: Date: <br />Problem: <br />Resolution: <br />2. Person Contacted: <br />Initiated By: <br />Problem: <br />Resolution: <br />(Please use the back of this sheet for additional c <br />contacts) <br />X30179 aunt <br />San Joaquin County EM <br />STIQ138328 <br />apb Oti110�101�{IIIII�IN1IW09 <br />111�� <br />J135—V 10 <br />iced or not, <br />VA <br />VA <br />/A <br />M <br />.5A4f <br />GL <br />
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