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WP0044129
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0044129
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Entry Properties
Last modified
10/3/2024 4:32:17 PM
Creation date
3/8/2023 1:46:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0044129
PE
4366
STREET_NUMBER
15363
Direction
N
STREET_NAME
TRETHEWAY
STREET_TYPE
RD
City
ACAMPO
Zip
95240-
APN
05120070
ENTERED_DATE
12/6/2022 12:00:00 AM
SITE_LOCATION
15363 N TRETHEWAY RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\gmartinez
Tags
EHD - Public
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FGL Environmental Doc ID:3DO900002_SOP_14.DOC <br /> Revision Date: 10/10/23 Page 1 of 1 <br /> Inter-Laboratory Condi ' on Receipt (Attach to COC) 50( <br /> Sample Receipt at: CC CH STK VI <br /> 1. Number of ice chests/packages received: Shipping tracking#(s): <br /> 2. Temp IR Gun ID #: MV <br /> 3. Were samples received on ick? Yes o Temps: <br /> Surface water SWTR bact samples:A at 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 /> 4. Do the number of bottles received agree with the COC? No N/A <br /> 5. Were samples received intact? (i.e. no broken bottles, leaks etc. Yes No N/A <br /> 6. VOAs checked for Headspace? No <br /> 7. Were all analyses within holding times at time of receipt? No <br /> 8. Verify sample date,time and sampler name No <br /> Sign and date the COC,place in a ziplock and put in the same ice chest as the samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: (p{� <br /> 1. Number of ice chests/packages received: ` Shipping tracking#(s): � <br /> 2. Temp IR Gun ID #: ?V I <br /> 3. Were samples received on ice? es No Temps: <br /> Acceptable is above freezing to 6°C. If m packages are received at one time check for t sts/H.T.'s/rushes/ <br /> 4. Do the number of bottles received agree with the COC? No N/A <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc.) a 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? 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? No N/A FGL <br /> lException: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? ix No <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): <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 /> 2. Person Contacted: __ - -- " t - - <br /> Initiated By: (3017919) <br /> Problem: haquin countyResolution: <br /> San <br /> W 1110112023 091819 <br /> (Please use the back of this sheet for additional comments o I�{I��I���I11111Ii1111�111 <br /> Ilillll� ` <br /> STK2355063 <br />
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