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COWPT5QMU (2)
EnvironmentalHealth
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2500 – Emergency Response Program
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COWPT5QMU (2)
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Entry Properties
Last modified
5/13/2024 8:52:14 AM
Creation date
8/25/2021 3:09:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COWPT5QMU
PE
2546
STREET_NUMBER
10749
Direction
W
STREET_NAME
WOODBRIDGE
STREET_TYPE
RD
City
LODI
Zip
95242
APN
01103013
ENTERED_DATE
3/26/2021 12:00:00 AM
SITE_LOCATION
10749 W WOODBRIDGE RD
RECEIVED_DATE
3/26/2021 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> McCampbell Analytical Inc. Toll Free Telephone: ( � )252- <br /> >_ � 9262/Fax: 9_5 9269 <br /> nIi7ten Quulhr Counts" http: �%�%w.nnccampbell.com/E-mail:main@mccampbell.com <br /> Sample Receipt Checklist <br /> Client Name: Excelchem Environmental Labs Date and Time Received: 4/2/2021 10:01 <br /> Project: 2103218 Date Logged: 4/2/2021 <br /> Received by: Tina Perez <br /> WorkOrder No: 2104071 Matrix: Sludge/Water Logged by: Tina Perez <br /> Carrier: FedEx <br /> Chain of Custody(COC)Information <br /> Chain of custody present? Yes © No❑ <br /> Chain of custody signed when relinquished and received? Yes ❑� No❑ <br /> Chain of custody agrees with sample labels? Yes 0 No❑ <br /> Sample IDs noted by Client on COC? Yes ❑d No❑ <br /> Date and Time of collection noted by Client on COC? Yes W No❑ <br /> Sampler's name noted on COC? Yes ❑ No❑d <br /> COC agrees with Quote? Yes ❑ No❑ NA <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes d❑ No❑ NA❑ <br /> Custody seals intact on sample bottles? Yes ❑ No❑ NA❑ <br /> Shipping container/cooler in good condition? Yes W No❑ <br /> Samples in proper containers/bottles? Yes W No❑ <br /> Sample containers intact? Yes W No❑ <br /> Sufficient sample volume for indicated test? Yes W No❑ <br /> Sample Preservation and Hold Time INTI Information <br /> All samples received within holding time? Yes ❑ No W NA❑ <br /> Samples Received on Ice? Yes W No❑ <br /> (Ice Type: BLUE ICE ) <br /> Sample/Temp Blank temperature Temp: 12°C NA❑ <br /> ZHS conditional analyses:VOA meets zero headspace Yes ❑ No❑ NAW <br /> requirement(VOCs,TPHg/BTEX, RSK)? <br /> Sample labels checked for correct preservation? Yes © No❑ <br /> pH acceptable upon receipt(Metal:<2; Nitrate 353.2/4500NO3: Yes ❑ No❑ NA❑d <br /> <2;522:<4;218.7:>8)? <br /> UCMR Samples: <br /> pH tested and acceptable upon receipt(200.8:.-52;525.3:s4, Yes ❑ No❑ NA W <br /> 530::57;541:<3; 544: <6.5&7.5)? <br /> Free Chlorine tested and acceptable upon receipt(<O.1 mg/L)? Yes ❑ No❑ NAW <br /> Comments: Method SM4500H+B(pH)was received past its 0.01-day holding time. <br /> Page 16 of 16 <br />
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