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WP0042024
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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4300 - Water Well Program
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WP0042024
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Entry Properties
Last modified
10/26/2022 8:55:21 AM
Creation date
10/5/2022 11:33:28 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0042024
PE
4370
STREET_NUMBER
1481
Direction
W
STREET_NAME
MANILA
STREET_TYPE
RD
City
LATHROP
Zip
95330-
APN
19127030
ENTERED_DATE
5/11/2021 12:00:00 AM
SITE_LOCATION
1481 W MANILA RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\tsok
Tags
EHD - Public
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FGL Environmental Doc ID: 3DO900002_SOP_12.1010C <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-L tory Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at: STK CC CH VI <br /> 1 . Number of ice ches s packages received: _Shipping tracking # <br /> J692. Were samples received in a chilled condition? Temps : <br /> Surface water S WTR 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? RNO <br /> No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) Ye <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 No / <br /> 8 . Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date, time and sampler namYes No <br /> Sign and date the COC, place in a ziplock and put in a ice chest as a samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP : <br /> 1 . Were samples received in a chilled condition? Temps : <br /> Acceptable is above freezing to 617 C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2: Shipping tracking numbers : <br /> 3 . Do the number of bottles received agree with the GOC? I c No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) s No <br /> 5 . Were sample custody seals intact? Yes No <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? e No <br /> 2 . Did bottle labels correspond with the client's ID' s? e No <br /> 3 . Were all bottles requiring sample preservation properly preserved? s No N/A FGL <br /> ]ExcepUen: 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 NIA <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 delive <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: (3017919) <br /> Resolution: San Joaquin County EHO <br /> 2 . Person Contacted: STK225��8111 <br /> Initiated By : <br /> Problem: >I <br /> Resolution: 111111111111�1111�i111111�1��1 <br /> s,KMza„ <br /> (Please use the back of this sheet for additic here <br /> ] <br /> contacts) <br />
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