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WP0042157
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042157
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Entry Properties
Last modified
3/18/2025 9:01:36 AM
Creation date
2/13/2023 1:54:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042157
PE
4380 - PUMP PERMIT - NEW
STREET_NUMBER
20555
Direction
N
STREET_NAME
BUCK
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
01721028
CURRENT_STATUS
Closed
QC Status
Approved
Scanner
SJGOV\gmartinez
Supplemental fields
Site Address
20555 N BUCK RD ACAMPO 95220-
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 /> Inter- ory Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at: STK C CH VI <br /> 1. Number of ice cages received: r Shippin tracking# <br /> 2. Were samples received in a chilled condition? Temps: ql / <br /> Surface water SWTR 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? No N/A <br /> 4. Were samples received intact?(i.e. no broken bottles, leaks etc.) es o <br /> 5. VOAs checked for Headspace? es N <br /> 6. Were sample custody seals intact? Yes No <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 Ye No <br /> Sign and date the COC,place in a ziplock and put in the same ice the mples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: <br /> P p <br /> Acceptable is above freezing to 6-w C. Ifpackages are received at one time check for tesWH.T.'s/rushes/ <br /> 2. Shipping tracking numbers:`S 5F1 W k-.6 <br /> y1Wk-.6 V`e) <br /> 3. Do the number of bottles received agree with the COC? CleZNo N/A <br /> es <br /> 4. Were samples received intact?(i.e. no broken bottles, leaks etc.) No <br /> 5. Were sample custody seals intact? Yes No /A <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? No <br /> 2. Did bottle labels correspond with the client's ID's? No <br /> 3. Were all bottles requiring sample preservation properly preserve Yes No N/A FGL <br /> [Exception: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 / <br /> 6. Were all analyses within holding times at time of receipt? Yes No <br /> Attach labels to the containers and include a copy of the COC fo 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 /> -- - -- (3911919) <br /> 2. Person Contacted: San Joaquin NO ERB <br /> Initiated By. <br /> Problem: STK2331201 <br /> Resolution: <br /> iv 01125!202316:19:56 <br /> (Please use the back of this sheet for addi er here <br /> contacts) 5TK2 SSl29l <br />
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