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WP0043835
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043835
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Entry Properties
Last modified
11/19/2024 10:20:03 AM
Creation date
4/3/2023 3:04:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043835
PE
4370
STREET_NUMBER
5161
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95304-
APN
25011002
ENTERED_DATE
9/23/2022 12:00:00 AM
SITE_LOCATION
5161 W ELEVENTH ST
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\gmartinez
Tags
EHD - Public
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FGL Environmental Doc ID:3D0900002_SOP_12.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-La to Condition Upon Receipt Attach to COC <br /> r3' P P ( <br /> Sample Receipt at: TK CC CH VI <br /> 1. Number of ice the packages received: -Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps:/'/ / <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.) Yes o <br /> 5. VOAs checked for Headspace? Yes No <br /> 6. Were sample custody seals intact? Yes No <br /> 7. If required, was sample split for pH analysis? Yes No IR <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date,time and sampler name ct No <br /> Sign and date the COC,place in a ziplock andput int same ice chest as the samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: t I .2. I 1 / 5 / Ll <br /> Acceptable is above freezing to 6-w C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: <br /> SSS1-0�� T / q3y / 530 G <br /> 3. Do the number of bottles received agree with the COC? �Ves <br /> No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> 5. Were sample custody seals intact? Yes No I(TA <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? Ys No <br /> 2. Did bottle labels correspond with the client's ID's? NQ No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No N/A FGL <br /> ]Exception:Oil&Grease,VOA and CM verified in lab] <br /> 4. VOAs checked for Headspace? Yes No IPA <br /> 5. Have rush or project due dates been checked and accepted? Yes No ItA <br /> 6. Were all analyses within holding times at time of receipt? Y@ No <br /> Attach labels to the containers and include a copy of the COC for b 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: "' " ' <br /> Initiated By: (3017919) <br /> Problem: San �Y <br /> Joaquin Coun EHD <br /> Resolution: STU331696 <br /> (Please use the back of this sheet for additional con iv 02/08/2023 09:24:05 <br /> contacts) III��I�I�Il1luU�ul��I�Ilulullll�V <br /> _ _ STK2331696 <br />
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