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WP0042352
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042352
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Entry Properties
Last modified
4/25/2024 12:08:54 PM
Creation date
2/16/2023 11:08:46 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042352
PE
4366
STREET_NUMBER
24184
Direction
S
STREET_NAME
CABE
STREET_TYPE
RD
City
TRACY
Zip
95304-
APN
25015028
ENTERED_DATE
7/28/2021 12:00:00 AM
SITE_LOCATION
24184 S CABE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\gmartinez
Tags
EHD - Public
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FOL Environ ental Doc ID: 3DO900002_SOP_12-4.DOC <br /> Revisiorn Date: 0/09/14 Page 1 of 1 <br /> me a ory Condition Upon Receipt (Attach to COC) ol0) <br /> Sample Recei tTK CC CH VI <br /> : <br /> 1. Number f packages received: _Shipping tracking# <br /> 2. Were s les received in a chilled condition? Temps:,O. <br /> Surface w er SWTR bact samples: A sample that has a temperature upon receipt of >I 0*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 n ber of bottles received agree with the COC? No N/A <br /> 4. Were s ples received intact? (i.e. no broken bottles, leaks etc. No <br /> 5. VOAs ch cked for Headspace? Yes No <br /> 6. Were s ple custody seals intact? Yes No I <br /> 7. If require , was sample split for pH analysis? No l <br /> 8. Were all alyses within holding times at time of receipt? o <br /> 9. Verify s ple date,time and sampler name e o <br /> 4chee Sign and date t e COC, place in a ziplock and put in s e ica samples. <br /> Sample Receip Review completed by (initials): <br /> Sample Recei at SP: 4- <br /> 1. Were s les received in a chilled condition? Temps: 1 / / / 3 / r <br /> Acceptable s above freezing to 6-w C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping I racking numbers: <br /> 3. Do the n ber of bottles received agree with the COC? � No N/A <br /> 4. Were sam les of <br /> intact? (i.e. no broken bottles, leaks etc.) a No <br /> 5. Were sam le custody seals intact? Yes No ZED <br /> Sign and date COC, obtain LIMS sample numbers, select methods/tests and print labels. <br /> Sample Verific tion, Labeling and Distribution: <br /> 1. Were all r quested analyses understood and acceptable? a No <br /> 2. Did bottle abels correspond with the client's ID's? No <br /> 3. Were all b ttles requiring sample preservation properly preserved? No N/A FGL <br /> (Exception:Oil&Grease,VOA and CrVI verified in labl <br /> 4. VOAs the ked for Headspace? Yes No <br /> 5. Have rush r project due dates been checked and accepted? Yesi No <br /> 6. Were all alyses within holding times at time of receipt? Y No <br /> Attach labels to he containers and include a copy of the COC for lab delivery. <br /> Sample Receipt, Login and Verification completed by (initials):_( AA/ <br /> Discrepancy D cumentation: <br /> Any items abov which are"No" or do not meet specifications (i.e. temps)must be resolved. <br /> 1. Person Co tacted: Phone Number: <br /> Initiated B Date: <br /> Problem: <br /> Resolution <br /> 2. Person Co cted: (3017919) <br /> Initiated B : San Joaquin County END <br /> Problem: <br /> Resolution: ST12230878 je � <br /> (Please use the b ck of this sheet for additional iv 0I1/f�18JI/I20�2�2 1�5(�::50f�:I00 <br /> contacts) — — - _ 11f 1011l1[QQI11 1111 1 <br /> i <br />
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