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CONKGIT0F (2)
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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JACK TONE
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1501
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2500 – Emergency Response Program
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CONKGIT0F (2)
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Entry Properties
Last modified
5/20/2021 1:55:11 PM
Creation date
5/20/2021 12:29:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CONKGIT0F
PE
2546
STREET_NUMBER
1501
Direction
N
STREET_NAME
JACK TONE
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
22811023
ENTERED_DATE
9/24/2020 12:00:00 AM
SITE_LOCATION
1501 N JACK TONE RD
RECEIVED_DATE
9/24/2020 12:00:00 AM
P_LOCATION
05
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> M c C a m p b e I l Analytical, Inc. Toll Free Telephone:(877)252-9262/Fax:(925)252-9269 <br /> "When Quality Counts" http://www.mccampbell.com/E-mail:main@mccampbell.com <br /> Sample Receipt Checklist <br /> Client Name: Ponder Environmental Services Date and Time Received: 9/28/2020 12:35 <br /> Project: 20-16350;Flying J Ripon Date Logged: 9/28/2020 <br /> Received by: Lilly Ortiz <br /> WorkOrder Ns: 2009E33 Matrix: Water Logged by: Lilly Ortiz <br /> Carrier: Client Drop-In <br /> Chain of Custody(COC)Information <br /> Chain of custody present? Yes d❑ No❑ <br /> Chain of custody signed when relinquished and received? Yes No❑ <br /> Chain of custody agrees with sample labels? Yes No❑ <br /> Sample IDs noted by Client on COC? Yes No❑ <br /> Date and Time of collection noted by Client on COC? Yes ❑ No❑ <br /> Sampler's name noted on COC? Yes No❑ <br /> COC agrees with Quote? Yes ❑ No❑ NA <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA d❑ <br /> Shipping container/cooler in good condition? Yes ❑d No❑ <br /> Samples in proper containers/bottles? Yes ❑ No <br /> Sample containers intact? Yes W No❑ <br /> Sufficient sample volume for indicated test? Yes ❑d No❑ <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? Yes ❑ Now NA❑ <br /> Samples Received on Ice? Yes ❑ Now <br /> Sample/Temp Blank temperature Temp: 29.2°C NA❑ <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ No❑ NA 0 <br /> Sample labels checked for correct preservation? Yes ❑ No W <br /> pH acceptable upon receipt(Metal:<2; Nitrate 353.2/4500NO3: Yes ❑ No❑d NA❑ <br /> <2;522:<4;218.7:>8)? <br /> UCMR Samples: <br /> pH tested and acceptable upon receipt(200.8:152; 525.3::54; Yes ❑ No❑ NA W <br /> 530::s7;541:<3;544:<6.5&7.5)? <br /> Free Chlorine tested and acceptable upon receipt(<O.1 mg/L)? Yes ❑ No❑ NA❑d <br /> Comments: Method SM4500H+B(pH)was received past its 0.01-day holding time.pH adjusted in Lab. <br /> Page 23 of 23 <br />
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