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WP0040607
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CLEMENTS
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18739
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040607
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Entry Properties
Last modified
12/27/2021 11:14:04 AM
Creation date
6/14/2021 4:27:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040607
PE
4366
STREET_NUMBER
18739
STREET_NAME
CLEMENTS
STREET_TYPE
RD
City
LODI
Zip
95240-
APN
01920038
ENTERED_DATE
3/6/2020 12:00:00 AM
SITE_LOCATION
18739 CLEMENTS 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_12-1.DOC <br />Page 1 of 1 <br />Inter- tory Condition Upon Receipt (Attach to COC) 2t <br />Sample Receip TK C CH VI <br />1. Number o ages received: _Shipping tracking # <br />2. Were samples received in a chilled condition? Temps: / 6,7 / <br />Surface water S WTR bact samples: A sample that has a temperature upon receipt of >I -0' 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 �NO <br />5. VOAs checked for Headspace? Yes <br />6. Were sample custody seals intact? Yes <br />7. If required, was sample split for pH analysis? <br />8. Were all analyses within holding times at time of receipt? <br />9. Verify sample date, time and sampler name _es <br />Sign and date the COC, place in a ziplock and put in s ice a samples. <br />Sample Receipt Review completed by (initials): <br />Sample Receipt at SP: <br />1. Were samples received in a chilled condition? Temps: Z- <br />Acceptable is above freezing to 60 C. if many packages are received at one time check for tests/H.T.'s/rushes/ <br />2. Shipping tracking numbers: <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.) es 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? 69No <br />2. Did bottle labels correspond with the client's ID's? e No <br />3. Were all bottles requiring sample preservation properly preserved? e No N/A FGL <br />(Exception: Oil & Grease, VOA and CM verified in labl <br />4. VOAs checked for Headspace? Yes No <br />5. Have rush or project due dates been checked and accepted? Yes No OA <br />6. Were all analyses within holding times at time of receipt? o 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: (3017919) <br />Initiated By: <br />Problem: San Joaquin County EHD <br />Resolution: STK2135658 <br />(Please use the back of this sheet for additiona apb 04/26/2021 16:26:17 :re <br />contacts) 11 111111 11111 <br />STK2135658 <br />
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