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WP0041064
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041064
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Entry Properties
Last modified
11/17/2021 1:48:53 PM
Creation date
10/19/2020 3:10:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041064
PE
4366
STREET_NUMBER
14110
Direction
S
STREET_NAME
CAMPBELL
STREET_TYPE
AVE
City
ESCALON
Zip
95320-
APN
20731009
ENTERED_DATE
8/6/2020 12:00:00 AM
SITE_LOCATION
14110 S CAMPBELL AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2020
Tags
EHD - Public
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Do the number of bottles received agree with the COC? Oft No <br /> Were samples received intact? (i.e. no broken bottles, leaks etc.) ON" No <br /> VOAs checked for Headspace? No <br /> Were sample custody seals intact? Yes No <br /> If required, was sample split for p1-1 analysis? Ye No <br /> Were all analyses within holding times at time of receipt? ea' No <br /> Verify sample date, time and sampler name No <br />N/A <br />N A <br />(3017919) <br />San Joaquin County EN <br />STK1139970 <br />FGL Environmental Doc ID: 3D0900002 _ _ SOP 12-3.DOC <br />Revision Date: 10/09/14 Page 1 of 1 <br />Inter-L <br />Sample Receipt at: <br />ap, atory Condition Upon Receipt (Attach to COC) 44 70 3 9' <br />CC CH VI <br />Number of ice ches s packages received: / Shipping tracking # <br />Were samples received in a chilled condition? Temps: (o. 5 / / / / <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 />Sign and date the COC, place in a ziplock and put in the e ice chest as the samples. <br />Sample Receipt Review completed by (initials): <br />Sample Receipt at SP: <br />Were samples received in a chilled condition? Temps: / <br />Acceptable is above freezing to 60 C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br />Shipping tracking numbers: <br />Do the number of bottles received agree with the COC? No N/A <br />Were samples received intact? (i.e. no broken bottles, leaks etc.) 4 No <br />Were sample custody seals intact? Yes No 6/1A <br />Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print labels. <br />Sample Verification, Labeling and Distribution: <br />Were all requested analyses understood and acceptable? <br />Did bottle labels correspond with the client's ID's? <br />Were all bottles requiring sample preservation properly preserved? Yes <br />[Exception: Oil & Grease, VOA and CrVI verified in lab] <br />VOAs checked for Headspace? No N/A <br />Have rush or project due dates been checked and accepted? Yes No '-NA <br />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 delivery. <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 />No <br />No <br />No FGL <br />2. Person Contacted: <br />Initiated By: <br />Problem: <br />Resolution: <br />(Please use the back of this sheet for additional <br />contacts)
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