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WP0040922
EnvironmentalHealth
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HORSE SHOE
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4300 - Water Well Program
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WP0040922
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Entry Properties
Last modified
6/7/2021 1:58:24 PM
Creation date
6/7/2021 1:34:58 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0040922
PE
4366
STREET_NUMBER
21301
Direction
N
STREET_NAME
HORSE SHOE
STREET_TYPE
CT
City
CLEMENTS
Zip
95227-
APN
01931009
ENTERED_DATE
6/29/2020 12:00:00 AM
SITE_LOCATION
21301 N HORSE SHOE CT
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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FGL Environmental Doc ID: 3DO900002_SOP_12-1.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-L tory Condition Upon Receipt (Attach to COC) J 5J 71 �► <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: 5,S / <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? Y No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) es No <br /> 5. VOAs checked for Headspace? Yes No <br /> 6. Were sample custody seals intact? Yes No <br /> 7. If required, was sample split for pH analysis? No /A <br /> vas <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date,time and sampler name Yes No <br /> Sign and date the COC, place in a ziplock and put in -e e 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: /4:5', <br /> Acceptable is above freezing to 60 C. If many packages are received at one time c ck for tests/H.T.'s/ shes/ <br /> 2. Shipping tracking numbers: <br /> � Z <br /> 3. Do the number of bottles received agree with the COC? <Z7MgL3 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? No <br /> 2. Did bottle labels correspond with the client's ID's? Ye No <br /> 3. Were all bottles requiring sample preservation properly preserved Yes No N/A FGL <br /> ]Exception:Oil&Grease,VOA and CrVI verified in lab] <br /> 4. VOAs checked for Headspace? Yes No R�2' <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? ®e No <br /> Attach labels to the containers and include a copy of the COC f v <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: _ Phone Number: <br /> Initiated By: <br /> (3017919) <br /> Problem: <br /> Resolution: San Joaquin County EHD <br /> (Please use the back of this sheet for additional cc STK2135171 <br /> contacts) aph 04/15/2021 16:36:11 <br /> II Illllllillllllllll IIIIIIIIIIII <br /> STK�1 5171 <br />
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