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WP0039060
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4200/4300 - Liquid Waste/Water Well Permits
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WP0039060
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Entry Properties
Last modified
1/9/2019 12:18:01 PM
Creation date
1/9/2019 10:36:52 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0039060
PE
4369
STREET_NUMBER
22100
Direction
N
STREET_NAME
BRUELLA
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
01719008
ENTERED_DATE
11/26/2018 12:00:00 AM
SITE_LOCATION
22100 N BRUELLA RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
DAfonskaia
Tags
EHD - Public
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Aug 28 17 04:52p Anthony Fuso 209-369-6576 p.1 <br /> ' I <br /> FGL Environmental Doc ID:3DO900002—SOP 12-2J*C <br /> Revision Date:10/0/14 Page 1 of 1 <br /> Intfer-La ory Condition Upon Receipt (Attach tD COC) � J�7 <br /> Sample Receipt CC CH Vt f <br /> I. Number of i e c es packages received: Shipping tracking# <br /> 2. Were sample received in a chilled condition? 'Temps: alr� / -1 I <br /> Surface nater WTR bact samples:Alsample that fins a temperature upon receipt of>} 'C,whether iced or not, <br /> should be flagged ucless the time since sample collection has been less than two flours. � <br /> 3. Do the number of bottles received agree with the COC? No N/A <br /> 4. Were sampl es received intact?(i.e.no broken bottles,leaks etc. No <br /> 5. VOAs cher for Headspace? No N/A <br /> 6. Were samplcustody seals intact? Yes N <br /> 7. If required,dray sample split ford pH analysis? Yes, o <br /> 8. Were all yses within holding times at time of receipt? est o <br /> 9. Verify camp a date,time and sampler name & No <br /> Sign and date the OC,place in a ziplock and put ' the same ice ch arnples. <br /> Sample Receipt Rumew completed by(initials): <br /> Sample Receipt at SP: <br /> 1. Were sampl received in a chilled condition? Temps: <br /> Acceptable is diove freezing to 6-C1 If many packages are recei at one time ch k for it�msfH.T.'sirushes/ <br /> 2. Shipping tracking numbers: 5-3�`ci (,{ C t �Lt <br /> 3. Do the number of bottles received agree with the COC? No N/A <br /> 4. Were samples received intact?(i.e. no broken bottles,leaks etc.) No <br /> 5. Were sampl�.,custody seals intact? Yes! No <br /> Sign and date the It,OC,obtain LIMS simple numbers, select methods/tests an print labels. <br /> Sample Verification,Labeling and Distribution: II II <br /> I. 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 bo es requiring sample preservation properly preserved? Yes No htn FOL <br /> [Exception-Qil&Grease,VOA and CrV1 verified in tabl <br /> 4. VOAs check for Headspace? A No <br /> 5. Have rush or project due bates been checked and accepted? es; No <br /> 6. Were all art yses within holding times at time of receipt? � No <br /> Attach labels to the containers and include a copy of the COC for lab deli Fry.I <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 Con cted:- Phone Number: <br /> Initiated By: Date: <br /> Problem: <br /> Resolution: <br /> 2. Person Conti teted- <br /> Initiated By: (3-18032) <br /> Problem: <br /> Ant,iiU►X , <br /> Resolution: i <br /> 0057 <br /> (Please use the ba(k of this sheet for additional comments or I I 5 <br /> contacts) IV 108/10/2017-16:20:40 <br />
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