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WP0041139
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041139
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Entry Properties
Last modified
12/27/2021 1:34:20 PM
Creation date
9/17/2020 9:06:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041139
PE
4370
STREET_NUMBER
15015
Direction
E
STREET_NAME
PELTIER
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
02108011
ENTERED_DATE
8/24/2020 12:00:00 AM
SITE_LOCATION
15015 E PELTIER 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_12-3.DOC <br />Page 1 of 1 <br />Inter -L story Condition Upon Receipt (Attach to COC) <br />Sample Receipt at: STK CC / CH VI <br />1. Number of ice ches s packages received: Shipping tracking # <br />2. Were samples received in a chilled condition? Temps: 4 . � / <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.) Yes No <br />5. VOAs checked for Headspace? Yes No <br />6. Were sample custody seals intact? Yes No <br />?. If required, was sample split for pH analysis? Yes No N/ <br />8. Were all analyses within holding times at time of receipt? No <br />9. Verify sample date, time and sampler nameWesamples. <br />No <br />Sign and date the COC, place in a ziplock and put in th s e ice chest a <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 LI C. If Z <br />/ages are receive¢ at one ti a check for tests/H� .T.'s/rush / h <br />2. Shippin tracki ber : Y JI `) % <br />xj� <br />3. Do the number of Ott es receivedwith the COC? No N/A <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.)e No <br />5. Were sample custody seals intact? es No /A <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? cm No <br />2. Did bottle labels correspond with the client's ID's? ' Y <br />No <br />3. Were all bottles requiring sample preservation properly preserved? Yes <br />No N/A FGL <br />(Exception: Oil & Grease, VOA and CrVI verified in labs <br />4. VOAs checked for Headspace? Yes <br />No <br />5. Have rush or project due dates been checked and accepted? Yes <br />No /A <br />6. Were all analyses within holding times at time of receipt? es <br />No <br />Attach labels to the containers and include a copy of the CO fo b <br />Sample Receipt, Login and Verification completed by (initia ): <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: <br />Problem: <br />Resolution: <br />(Please use the back of this sheet for additional cc <br />contacts) <br />(3017919) <br />San Joaquin County EHD <br />STK2132718 <br />iv 02/2512021 15:52:58 <br />
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