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WP0041603
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041603
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Entry Properties
Last modified
12/21/2021 2:49:03 PM
Creation date
12/8/2021 9:53:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041603
PE
4366
STREET_NUMBER
25753
Direction
N
STREET_NAME
TULLY
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
02103033
ENTERED_DATE
1/12/2021 12:00:00 AM
SITE_LOCATION
25753 N TULLY RD
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 Doc ID: 2D09001.57_SOP_17-1.DOC <br /> Revision Date: 10/09/14 Page: 1 of 1 <br /> In-House Condition Upon Receipt (Attach to COC) <br /> CC CH STK VI SP <br /> Sample Receipt: <br /> 1. Number of ice chests/packages received: <br /> 2. Shipper tracking numbers <br /> 3. Were samples received in a chilled condition? Temps: <br /> 4. Surface water (S WTR) bact samples: A sample that has a temperature upon receipt of>I O'C' <br /> whether iced or not, should be flagged unless the time since sample collection has been less than <br /> two hours. <br /> 5. Do the number of bottles received agree with the COC? Ye No N/A <br /> 6. Verify sample data, time, sampler <M� No <br /> 7. Were samples received intact? (i.e. no broken bottles, leaks etc.) � No <br /> 8. Were sample custody seals intact? Yes No D/A <br /> Sample Verification, Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? Yes 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 /A FGL <br /> [Exception:Oil&Grease,VOA and CrVI verified in labs <br /> 4. VOAs checked for Headspace? No N/A <br /> 5. Were all analyses within holding times at time of receipt? C- No <br /> 6. Have rush or project due dates been checked and accepted? fA Yes No <br /> Include a copy of the COC for lab delivery. (Bacti, Inorganics and Radio) <br /> Sample Receipt, Login and Verification completed by (initials): <br /> Discrepancy Documentation: (attach additional pages if needed) <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: Date: <br /> Problem: <br /> Resolution: <br /> Attach label with lab number here <br /> Use this form.when all containers are staying; in the lab and not being shipped to FGL-SP <br />
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