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WP0043695
EnvironmentalHealth
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120 (STATE ROUTE 120)
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12870
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043695
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Entry Properties
Last modified
11/19/2024 4:01:51 PM
Creation date
6/20/2023 8:41:18 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043695
PE
4370
STREET_NUMBER
12870
Direction
E
STREET_NAME
STATE ROUTE 120
City
MANTECA
Zip
95336-
APN
22804005
ENTERED_DATE
8/31/2022 12:00:00 AM
SITE_LOCATION
12870 E HWY 120
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\gmartinez
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-L to Condition Upon Receipt Attach to COC 93��`3`5 <br /> rY P P { <br /> Sample Receipt at: 9 CC CH VI <br /> 1. Number of ice chests/packages received: f 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 >100 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 <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 nam Ite <br /> No <br /> Sign and date the COC,place in a ziplock and put in t e ame ice chest amples. <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: 1410 q W Vq p <br /> 41,g4/ <br /> 3. Do the number of bottles received agree with the COM Yaw No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) CYas No <br /> 5. Were sample custody seals intact? Yes No (NA <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? Vw No <br /> 2. Did bottle labels correspond with the client's ID's? V-et No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No N/A FGL <br /> lException:Oil&Grease,VOA and CM verified in labl <br /> 4. VOAs checked for Headspace? Yes No �.blA <br /> 5. Have rush or project due dates been checked and accepted? Yes No CIA <br /> 6. Were all analyses within holding times at time of receipt? Ye 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: Phone Number: <br /> Initiated By: - nqt <br /> Problem: (3017919) <br /> Resolution: San Joaquin CountyEHD <br /> (Please use the back of this sheet for additional com <br /> contacts) STU336735 <br /> iv 05125/2023 07:57:21 <br /> NN1111111111111111111 <br /> M2336733 <br />
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