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WP0043254
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ESCALON BELLOTA
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043254
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Last modified
8/30/2023 4:33:09 PM
Creation date
5/1/2023 11:11:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043254
PE
4378
STREET_NUMBER
13035
Direction
S
STREET_NAME
ESCALON BELLOTA
STREET_TYPE
RD
City
ESCALON
Zip
95320-
APN
20719034
ENTERED_DATE
5/2/2022 12:00:00 AM
SITE_LOCATION
13035 S ESCALON BELLOTA RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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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-L haratory Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at: STK CC CH VI <br /> 1. Number of ice chests/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.) Ye No <br /> 5. VOAs checked for Headspace? Yes No <br /> 6. Were sample custody seals intact? Yes No NQ--, <br /> 7. If required, was sample split for pH analysis? Yes No <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date, time and sampler name Yes No <br /> Sign and date the COC,place in a ziplock and put in th a 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: <br /> Acceptable is above freezing to 6❑ C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: n r� <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.) <br /> 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? Ya—1 No <br /> 2. Did bottle labels correspond with the client's ID's? No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No 1 1� FGL <br /> [Exception:Oil&Grease,VOA and CrVI verified in lab] <br /> 4. VOAs checked for Headspace? Mes No NIA <br /> 5. Have rush or project due dates been checked and accepted? Yes No (I/A <br /> 6. Were all analyses within holding times at time of receipt? /QXs No <br /> Attach labels to the containers and include a copy of the COC for livery. <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 Joaquin County EHO <br /> Resolution: STU335135 <br /> (Please use the back of this sheet for additional cc iv 04/26/2023 07:57:42 <br /> contacts) �ll�lllllll��llli�l <br /> l lllll�ll➢IIS <br /> STK2335135 <br />
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