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WP0043259
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FOREST CREEK
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043259
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Entry Properties
Last modified
10/11/2022 10:09:43 AM
Creation date
10/11/2022 9:46:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043259
PE
4381
STREET_NUMBER
4277
Direction
E
STREET_NAME
FOREST CREEK
STREET_TYPE
LN
City
GALT
Zip
95632-
APN
00511021
ENTERED_DATE
5/2/2022 12:00:00 AM
SITE_LOCATION
4277 E FOREST CREEK LN
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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Tags
EHD - Public
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FGL Environmental <br />Revision Date: 10/09/14 <br />Doc ID: 3DO900002 SOP 12-2.DOC <br />Page 1 of 1 i <br />t Condition Upon Receipt (Attach to COC) 0055Z15 <br />in a ry <br />1�amDle Receiut STK .)Cc t CH VI <br />I. fvumber of ite-ehestsr c ages received: _Shipping tracking # <br />2. Were samples received in a chilled condition? Temps: <br />0r,rface water SWTR bact samples: A sample that has a temperature upon receipt of > 10° C, wh�ther iced or not, <br />should be flagged unless the time since sample collection has been less than two hours. 1 <br />3. Do the number of bottles received agree with the COC? No I N/A <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc. No . <br />5. VOAs checked for Headspace? No i N/A <br />6. Were sample custody seals intact? Yes No i <br />7. If required, was sample split for pH analysis? No <br />8. Were all analyses within holding times at time of receipt? No <br />9. Verify sample date, time and sampler name es No <br />Sign and date the COC, place in a ziplock and put i the same ice ch samples. <br />Sample Receipt Review completed by (initials):_WZ <br />Sample Receipt at SP: <br />1. Were samples received in a chilled condition? Temps: <br />Acceptable is above freezing to 69 C. if many packages are received at one time check for tesWH.T.'s rushes/ <br />2. Shipping tracking numbers: <br />3. Do the number of bottles received agree with the COC? es No I N/A <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) e No i <br />5. Were sample custody seals intact? Yes No 'l / <br />Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print labels. <br />Sample Verification, Labeling and Distribution: <br />I . Were all requested analyses understood and acceptable? No <br />Did bottle labels correspond with the client's ID's? No <br />3. Were all bottles requiring sample preservation properly preserved? No i N/A FGL <br />(Exception: Oil & Grease, VOA and CM verified in labl <br />i <br />4. VOAs checked for Headspace? Yes No <br />5. Have rush or project due dates been checked and accepted? Yes No I / <br />6. Were all analyses within holding times at time of receipt? n' No II <br />Attach labels to the containers and include a copy of the COC for lab delivery. <br />Sample Receipt, Login and Verification completed by (initials): 4 <br />Discrepancy Documentation: l <br />An items above which are "No" or do not meet specifications (i.e. temps) must be resolved. <br />y I <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 additi, <br />contacts) <br />Phone Number: I <br />(3019140) <br />Ramon Gomel --� <br />STK2232545 here <br />iv 02/23/2022 0):0849 <br />U111111111111111' <br />
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