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** PLEASE CHECK LOOKUP - if good, then Approve QCStatus, else update with correct RECORD_ID
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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V
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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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** PLEASE CHECK LOOKUP - if good, then Approve QCStatus, else update with correct RECORD_ID
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Entry Properties
Last modified
10/21/2024 4:15:18 PM
Creation date
12/31/2020 8:17:23 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200 – Liquid Waste Program
RECORD_ID
PR0521836
PE
4232 - ALT/ENG OWTS - ANNUAL PERMIT - Full Permit
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
Active, billable
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
17950 W VIA NICOLO TRACY 95377
Tags
EHD - Public
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FGL Environmental Doc ID: 3DO900002_SOP_12.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-La tory Condition Upon Receipt (Attach to COC)20 553 Ze <br /> Sample Receipt at: STK CC / CH VI <br /> 1. Number of ice c packages received: Shipping tracking <br /> -# <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 >101 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? es No N/A <br /> 4. Were samples received intact?(i.e. no broken bottles, leaks etc.) No <br /> 5. VOAs checked for Headspace? a No N/A <br /> 6. Were sample custody seals intact? Yes No 41SM <br /> 7. If required, was sample split for pH analysis? Yes No /13!ff) <br /> 8. Were all analyses within holding times at time of receipt? a No <br /> 9. Verify sample date,time and sampler name a No <br /> Sign and date the COC, place in a ziplock and put in th a 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: <br /> Acceptable is above freezing to 6—C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: FJ�d p\C1.0Sa Cl IS-Gj340 <br /> 3. Do the number of bottles received agree with the COC? n No N/A <br /> 4. Were samples received intact?(i.e. no broken bottles, leaks etc.) � 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 labels. <br /> Sample Verification,Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? YtA No <br /> 2. Did bottle labels correspond with the client's ID's? No <br /> 3. Were all bottles requiring sample preservation properly preserved? No N/A FGL <br /> (Exception:Oil&Grease,VOA and CrVI verified in labl <br /> 4. VOAs checked for Headspace? Yes No ltx <br /> 5. Have rush or project due dates been checked and accepted? Yes No <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 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 /> 2. Person Contacted: <br /> Initiated By: (3011544) <br /> Problem: <br /> Resolution: Musco FaOlive Environmental <br /> (Please use the back of this sheet for additional c, ST1055328 <br /> contacts) cic 1012912020 16:17:05 <br />
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