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ARCHIVED REPORTS_MONIT RPTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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VIA NICOLO
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17950
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4200 – Liquid Waste Program
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PR0521836
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ARCHIVED REPORTS_MONIT RPTS
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Last modified
12/4/2020 9:15:18 AM
Creation date
8/5/2020 10:11:57 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200 – Liquid Waste Program
File Section
ARCHIVED REPORTS
FileName_PostFix
MONIT RPTS
RECORD_ID
PR0521836
PE
4232
FACILITY_ID
FA0002971
FACILITY_NAME
MUSCO FAMILY OLIVE CO
STREET_NUMBER
17950
Direction
W
STREET_NAME
VIA NICOLO
City
TRACY
Zip
95377
APN
20911032
CURRENT_STATUS
01
SITE_LOCATION
17950 W VIA NICOLO
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\4200 - Liquid Waste\V\VIA NICOLO\17950\PR0521836\MONIT RPTS.PDF
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EHD - Public
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FGL Environmental Doc ID:3DO900002_SOP_12-1.DOC <br /> Revision Date: 10/09/14 Page I of 1 <br /> Inter-Laboratory Condition Upon Receipt (Attach to COC) /-5 <br /> Sample Receipt at: CC CH VI <br /> 1. Number of ice packages received: Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps: 1215/ <br /> Surface water SWTR bact samples:A sample that has a temperature upon receipt of >IO°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? a No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles,leaks etc.) No <br /> 5. VOAs checked for Headspace? No N/A <br /> 6. Were sample custody seals intact? Yes No -,WrA-_') <br /> 7. If required, was sample split for pH analysis? Ym No <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date,time and sampler name No <br /> Sign and date the COC,place in a ziplock and put ' same ice chest as the samples. <br /> Sample Receipt.Review completed by(initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: 3 / 1-741 <br /> Acceptable is above freezing to 64�C. If many packages are received at one time check for tests/H.T.'s/rashes/ <br /> 2. Ship ing tracking numbers: <br /> 1 lel(��2sre2eivl�ID� <br /> 3. Do e number of bottled agree with the COC? ��No N/A <br /> 4. Were samples received intact? (i.e.no broken bottles, leaks etc.) < (s No <br /> 5. Were sample custody seals intact? Yes No <br /> Sign and date the COC,obtain LIMS sample numbers, select methods/tests and print Labe s. <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. e No N/A FGL <br /> [Exception:Oil&Grease,VOA and CrVI verified in lab) <br /> 4. VOAs checked for Headspace? <:YgP No <br /> 5. Have rush or project due dates been checked and accepted? Yes No N/A <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 fo ' ery. <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. t )must be resolved. <br /> 1. Person Contacted: Phone Number: <br /> Initiated By: Date: <br /> Problem: <br /> Resolution: <br /> 2. Person Contacted: Phone Number: <br /> Initiated By: (3-11544) <br /> Problem: MUSCO Family Olive Environmental <br /> Resolution: S my 15 5 318 6 <br /> (Please use the back of this sheet for additional comments IV-112i/`03/2015-12:052:50 <br /> contacts) <br />
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