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WP0042272
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042272
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Entry Properties
Last modified
10/27/2021 2:09:17 PM
Creation date
10/27/2021 2:01:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042272
PE
4380
STREET_NUMBER
10897
Direction
E
STREET_NAME
COLLIER
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
00714029
ENTERED_DATE
7/12/2021 12:00:00 AM
SITE_LOCATION
10897 E COLLIER RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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FGL Environmental <br />Revision Date: 10/09/14 <br />Doc ID: 3D0900002_SOP_12-3.DOC <br />Page 1 of 1 <br />Inter -L tory Condition Upon Receipt (Attach to COC) a1J�4-7 <br />Sample Receipt at: STK CC CH VI <br />1. Number of ice ch packages received: _Shipping tracking # <br />2. Were samples received in a chilled condition? Temps:(71 / / / / <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.) C Ye 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 N/A <br />8. Were all analyses within holding times at time of receipt? No <br />9. Verify sample date, time and sampler namePesamples. <br />No <br />Sign and date the COC, place in a ziplock and put in the ice chest as t <br />Sample Receipt Review completed by (initials): <br />Sample Receipt at SP: <br />1. Were samples received in a chilled condition? Temps: JZ <br />Acceptable is above freezing to 6E C. If many packages are received at one time check for tesWH.T.'s/rushes/ <br />2. Shipping tracking numbers: <br />55WSC OD - <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.) No <br />5. Were sample custody seals intact? Yes No 1/ <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? <br />No <br />2. Did bottle labels correspond with the client's ID's? <br />No <br />3. Were all bottles requiring sample preservation properly preserved? <br />No N/A FGL <br />(Exception: Oil & Grease, VOA and CrVI verified in labl <br />4. VOAs checked for Headspace? Yes <br />No <br />5. Have rush or project due dates been checked and accepted? Y <br />No <br />6. Were all analyses within holding times at time of receipt? e <br />No <br />ry. <br />Attach labels to the containers and include a copy of the COC for lat�A <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 <br />be resolved. <br />1. Person Contacted: Phone Number: <br />Initiated By: Date: <br />Problem: <br />Resolution: <br />2. <br />Person Contacted: <br />Initiated By: <br />Problem: <br />Resolution: <br />(Please use the back of this sheet for additional corn <br />contacts) <br />Phone Number: <br />(3017919) <br />San Joaquin County EHO <br />STU153047 <br />Iv 09113/202115:49:47 <br />II 11111111111111H <br />
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