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WP0040948
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040948
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Entry Properties
Last modified
12/27/2021 11:30:49 AM
Creation date
8/20/2020 10:52:00 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040948
PE
4366
STREET_NUMBER
16475
Direction
S
STREET_NAME
TIDE
STREET_TYPE
RD
City
RIPON
Zip
95366-
APN
20310017
ENTERED_DATE
7/6/2020 12:00:00 AM
SITE_LOCATION
16475 S TIDE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2020
Tags
EHD - Public
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FGL Environmental <br />Revision Date: 10/09/14 <br />Doc ID: 3DO900002_SOP_12-1.DOC ' <br />Page 1 of 1 <br />Inter -L tory Condition Upon Receipt (Attach <br />Sample Receipt at:STK CC CH VI <br />1. Number of ice ches s/packages received: Shipping tracking # <br />to COC) <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. <br />Do the number of bottles received agree with the COC? <br />KYes No <br />N/A <br />4. <br />Were samples received intact? (i.e. no broken bottles, leaks etc.)No <br />M <br />5. <br />VOAs checked for Headspace? <br />No <br />N/A <br />6. <br />Were sample custody seals intact? <br />Yes No <br />7. <br />If required, was sample split for pH analysis? <br />Yes No <br />N/A <br />8. <br />Were all analyses within holding times at time of receipt? <br />No <br />9. <br />Verify sample date, time and sampler name <br />No <br />Pesamples. <br />Sign and date the COC, place in a ziplock and put in t e e ice chest <br />Sample Receipt Review completed by (initials): <br />as t <br />Sample Receipt at SP: / <br />1. Were samples received in a chilled condition? Tem <br />Acceptable is above freezing to 66) C. If many packages are r eived at one time check for tests/H.T.'s/rushes/ <br />2. Shipping tracking numbers: 11 / <br />3. Do the number of bottles received agree it the COC? OTFNo N/A <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.)Tesb <br />No <br />5 Were sample custody seals intact? 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? <e 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 (� J FGL <br />[Exception: Oil & Grease, VOA and CrVI verified in labl <br />4. VOAs checked for Headspace? c2b No KLA <br />5. Have rush or project due dates been checked and accepted? Yes No �/A <br />6. Were all analyses within holding times at time of receipt? CM No <br />Attach labels to the containers and include a copy of the C f b ry. <br />Sample Receipt, Login and Verification completed by (initi <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: <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 />Date: <br />(3017919) <br />San Joaquin County EHD <br />STK2132324 <br />iv 0211612021 15:59:12 <br />
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