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WP0041905
EnvironmentalHealth
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HARMONY GROVE
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11852
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4300 - Water Well Program
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WP0041905
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Last modified
4/27/2022 10:59:21 AM
Creation date
4/27/2022 10:55:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0041905
PE
4366
STREET_NUMBER
11852
Direction
E
STREET_NAME
HARMONY GROVE
STREET_TYPE
RD
City
LOCKEFORD
Zip
95237-
APN
05118036
ENTERED_DATE
4/7/2021 12:00:00 AM
SITE_LOCATION
11852 E HARMONY GROVE 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: 2D0900157_SOP_17.DOC <br />Page: 1 of 1 <br />In -House Condition U eipt (Attach to COC) 4 33 74� <br />CC C STK VI SP <br />Sample Receipt: r <br />1. Number of ice chests/packages received: <br />2. Shipper tracking numbers <br />3. Were samples received in a chilled condition? Temps: /1. 4/ <br />4. Surface water (S WTR) bact samples: A sample that has a temperature upon receipt of >I 01C, <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? es No N/A <br />6. Verify sample data, time, sampler Yes No <br />7. Were samples received intact? (i.e. no broken bottles, leaks etc.) Yes No <br />8. Were sample custody seals intact? Yes No (MD <br />Sample Verification, Labeling and Distribution: <br />1. Were all requested analyses understood and acceptable?es o <br />2. Did bottle labels correspond with the client's ID's? Yes o <br />3. Were all bottles requiring sample preservation properly preserved? Yes No FGL <br />Exception: Oil & Grease, VOA and CM verified in labs <br />4. VOAs checked for Headspace? Yes No / <br />5. Were all analyses within holding times at time of receipt? No <br />6. Have rush or project due dates been checked and accepted? (:N/DAYes 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 />F1 <br />Resolution: <br />Person Contacted: <br />Initiated By: <br />Problem: <br />Phone Number: <br />Date: <br />Resolution: <br />Attach label with lab number here <br />Use this form when all containers arc staying in the late and not being shipped to FGL-SP <br />
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