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WP0041796
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041796
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Entry Properties
Last modified
12/27/2021 2:10:50 PM
Creation date
7/7/2021 3:00:24 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041796
PE
4370
STREET_NUMBER
20655
Direction
E
STREET_NAME
AYERS
STREET_TYPE
AVE
City
ESCALON
Zip
95320-
APN
20509038
ENTERED_DATE
3/11/2021 12:00:00 AM
SITE_LOCATION
20655 E AYERS AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\tsok
Supplemental fields
CYEAR
2021
Tags
EHD - Public
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FGL Environmental <br />Revision Date: 10/09/14 <br />Doc ID: 3DO900002_SOP_12-3.DOC <br />Page 1 of 1 <br />Inter -L tory Condition Upon Receipt (Attach <br />Sample Receipt at: STK CC CH VI <br />1. Number of ice chests packages received: Shipping tracking # <br />to COC) 0?137A1gJ <br />2. Were samples received in a chilled condition? Temps: / I , / <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? No N/A <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) Yes 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? Yes /A <br />8. Were all analyses within holding times at time of receipt? Vac No <br />9. Verify sample date, time and sampler name Pesampleg--;;�,14�/"4-� <br />No <br />Sign and date the COC, place in a ziplock and put i same ice chest as <br />Sample Receipt Review completed by (initials): <br />Sample Receipt at SP: <br />1. Were samples received in a chilled condition? Temps: / �/ / 6 <br />Acceptable is above freezing to 6U C. If many packages are received one time check for tests/H.T.'s/rushes/ <br />2. Ship ing trac rs: <br />U(� <br />3. Do the number of bottles received agree with the COC. e 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 1,02 <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? No <br />3. Were all bottles requiring sample preservation properly preserved? es No N/A FGL <br />[Exception: Oil & Grease, VOA and CM verified in lab] <br />4. VOAs checked for Headspace? Yes No <br />5. Have rush or project due dates been checked and accepted? Yes No N:6 <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: (3017919) <br />Initiated By: San Joaquin County EHD <br />Problem: <br />Resolution: STK2137441 <br />(Please use the back of this sheet for additi apb 05126/2021 17:44:17 r here <br />contacts) 1111111ST 11 <br />Illllllllllllllllllll <br />
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