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4200 – Liquid Waste Program
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PR0544130
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COMPLIANCE INFO
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Last modified
12/21/2022 9:38:55 AM
Creation date
12/20/2022 3:59:57 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200 – Liquid Waste Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0544130
PE
4233
FACILITY_ID
FA0025094
FACILITY_NAME
MARTINEZ, MARCELINO
STREET_NUMBER
3243
Direction
E
STREET_NAME
LATHROP
STREET_TYPE
RD
City
MANTECA
Zip
95336
CURRENT_STATUS
01
SITE_LOCATION
3243 E LATHROP RD
P_LOCATION
04
QC Status
Approved
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SJGOV\lsauers
Tags
EHD - Public
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FGL Environmental Doc ID:3DO900002_SOP_12.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> InteMs <br /> atory Condition Upon Receipt (Attach to COC) �a5�3�� <br /> Sample Receipt at: C CH VI <br /> 1. Number of icec ages received: r Shipping tracking# <br /> ,J <br /> 2. Were samples received in a chilled condition? Temps: �•T/ <br /> Surface water SWTR bact samples:A sample that has a temperature upon receipt of >101 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 a No <br /> 5. VOAs checked for Headspace? es No <br /> 6. Were sample custody seals intact? Yes No <br /> 7. If required, was sample split for pH analysis? N <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 in the same ice ches amples. <br /> Sample Receipt Review completed by (initials): Ag-) <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: a-/ <br /> Acceptable is above freezing to 60 C. if many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. hi tracking numbers: TA37(M/ <br /> r:),A I tocorl, <br /> 3. Do the number of bottles received agree with t e COC? s No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) es 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? a No <br /> 2. Did bottle labels correspond with the client's ID's? a No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No FGL <br /> [Exception:Oil&Grease,VOA and CrVI verified in labl <br /> 4. VOAs checked for Headspace? Yes No <br /> 5. Have rush or project due dates been checked and accepted? Ye No / <br /> 6. Were all analyses within holding times at time of receipt? a No <br /> Attach labels to the containers and include a copy of the COC fo lab delivery. <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: <br /> Resolution: <br /> (3017919) <br /> 2. Person Contacted: San Joaquin CounW EHD <br /> Initiated By: <br /> Problem: STU257371 <br /> Resolution: <br /> iv 1210812022 07:17:52 <br /> (Please use the back of this sheet for additi( UII�Illllllll��lllllllllll�llllll{ .here <br /> contacts) STK2257371 <br />
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