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WP0039502
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4200/4300 - Liquid Waste/Water Well Permits
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WP0039502
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Entry Properties
Last modified
12/27/2021 11:07:56 AM
Creation date
5/24/2019 3:59:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0039502
PE
4366
STREET_NUMBER
4855
Direction
E
STREET_NAME
BRUNSWICK
STREET_TYPE
RD
City
MANTECA
Zip
95336-
APN
19704010
ENTERED_DATE
4/8/2019 12:00:00 AM
SITE_LOCATION
4855 E BRUNSWICK RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2019
Tags
EHD - Public
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FGL Environmental <br />Revision Date: 10/09/14 <br />Doe ID: 3DO900002_SOP_12-1.DOC <br />Page 1 of 1 <br />Inter -L btKatory Condition Upon Receipt (Attach to COC) -7134a 1 <br />r <br />Sample Receipt at: (ISTN CC CH VI <br />1. Number of ice chests/packages received: Shipping tracking # <br />2. Were samples received in a chilled condition? Temps: /1. 6 / <br />Surface water SWTR bact samples: A sample 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 two hours. <br />3. Do the number of bottles received agree with the COC? <br />No N/A <br />ZNo <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) <br />5. VOAs checked for Headspace? <br />Yes No <br />6. Were sample custody seals intact? <br />Yes, No <br />7. If required, was sample split for pH analysis? <br />Yes No <br />8. Were all analyses within holding times at time of receipt? <br />No <br />9. Verify sample date, time and sampler name <br />Yes No <br />e ice chest <br />Sign and date the COC, place in a ziplock and pn�� <br />as the samples. <br />Sample Receipt Review completed by (initials): <br />Sample Receipt at SP: 5 4�-S <br />1. Were samples received in a chilled condition? Temps: <br />Acceptable is above freezing to 6 B C. If ma7ee <br />ackages are received at ne time check forte ts/H.T.'s/rushes/ <br />2. Sh� ing trackin numbers: �\ <br />3. Do the num er of bottles received agwith the COC? e No N/A <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) es No <br />5. Were sample custody seals intact? es No fN�A <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? No <br />2. Did bottle labels correspond with the client's ID's? No <br />3. Were all bottles requiring sample preservation properly preserved? es No N/A FGL <br />[Exception: Oil & Grease, VOA and CrVI verified in lab] <br />4. VOAs checked for Headspace? Yes No ell - <br />6. <br />5. Have rush or project due dates been checked and accepted? Yes No Were all analyses within holding times at time of receipt?e No <br />Attach labels to the containers and include a copy of the COC for lab del very. <br />Sample Receipt, Login and Verification completed by (initials): `Com-' <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 County END <br />Problem: STU136230 <br />Resolution: <br />apb 05/06/2021 16:53:25 fere <br />(Please use the back of this sheet for additior IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII <br />contacts) <br />
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