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SU0010760_SSNL
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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99 (STATE ROUTE 99)
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2600 - Land Use Program
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PA-1600008
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SU0010760_SSNL
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Entry Properties
Last modified
11/19/2024 1:52:20 PM
Creation date
9/8/2019 12:56:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0010760
PE
2625
FACILITY_NAME
PA-1600008
STREET_NUMBER
24511
Direction
N
STREET_NAME
STATE ROUTE 99
City
ACAMPO
Zip
95220-
APN
00516015
ENTERED_DATE
1/22/2016 12:00:00 AM
SITE_LOCATION
24511 N HWY 99
RECEIVED_DATE
1/22/2016 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Supplemental fields
FilePath
\MIGRATIONS\N\HWY 99\24511\PA-1600008\SU0010760\SS_NL STUDY .PDF
Tags
EHD - Public
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N(ii,Environmental lloe ill:31109000UZ 5Ur 1Z-11.DUC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-Ltory Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at: STK CC CH VI <br /> 1. Number of ice chests packages received: I Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps: <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? No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> 5. VOAs checked for Headspace? es No <br /> 6. Were sample custody seals intact? Yes No cbzp <br /> 7. If required, was sample split for pH analysis? Yes No <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date, time and sampler name es No <br /> Sign and date the COC,place in a ziplock and put in the s e ice chest as amples. <br /> Sample Receipt Review completed by(initials. <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 6,N C' If any packages are r ved at one time check for tests/H.T.'shvshes/ <br /> 2. Ship ing n bers: ����'G <br /> 3. Do the number of bottles receiv agree with the COC? No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) ee No <br /> 5. Were sample custody seals intact? Yes No 9P <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? es No <br /> 3. Were all bottles requiring sample preservation properly preserved? es No /A FGL <br /> IEzception:Oil&Grease,VOA and CrVl verified in labl <br /> 4. VOAs checked for Headspace? e No N/A <br /> 5. Have rush or project due dates been checked and accepted? es Not <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 delive <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: <br /> Initiated By: n i. �r,.:rnr n • 7 <br /> Problem: �Y� ��,, �' Li1Vil'vlaii i16Q1 <br /> Resolution: C mrr 1 -7 1 '1 t., 1 rj <br /> Ui1\1 i JJJJL <br /> (Please use the back of this sheet for additional con fere <br /> _ _. . . --_'--__ . . .._ _.. 1V-¢i3i 27i2411�i-1u:v,i:ori <br /> contacts) _. . _ <br />
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