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WP0044053
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0044053
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Entry Properties
Last modified
5/29/2024 4:46:56 PM
Creation date
10/23/2023 10:53:53 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0044053
PE
4378
STREET_NUMBER
16728
Direction
E
STREET_NAME
ELSHOLZ
STREET_TYPE
RD
City
RIPON
Zip
95366-
APN
20322008
ENTERED_DATE
11/14/2022 12:00:00 AM
SITE_LOCATION
16728 E ELSHOLZ RD
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_14.DOC <br /> Revision Date: 10/10/23 Page 1 of 1 <br /> Inter-Laboratory Cond' ' on Receipt (Attach to COC) a455110 <br /> Sample Receipt at: CC CH ST VI <br /> 1. Number of ice chests/packages received: _� Shipping tracking#(s): <br /> 2. Temp IR Gun ID #: 'Vt Vj a <br /> 3. Were samples received on is Yes o Temps: <br /> Surface water SWTR bact samples. p e 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 /> 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 etJ No <br /> 6. VOAs checked for Headspace? Yes N =N/A <br /> 7. Were all analyses within holding times at time of receipt? No a Std <br /> 8. Verify sample date, time and sampler name Yes) No C lib <br /> Sign and date the COC,place in a ziplock and put in m ice the s e samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Number of ice chests/packages received: Shipping tracking#(s): <br /> 2. Temp IR Gun ID #: THu'6 _? lqg17 <br /> 3. Were samples received on ice? ,"ee No Temps: �'�- / / / / <br /> Acceptable is above freezing to 6°C. If y packages are received at one time check for tests/H.T.'s/rushes/ <br /> 4. Do the number of bottles received agree with the COC? l� No N/A <br /> 5. Were samples received intact? (i.e. no broken bottles, leaks etc.) Td 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? Ye No <br /> 2. Did bottle labels correspond with the client's ID's? YM 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 V/- <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? UesNo <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: Date: <br /> Problem: (3017919) <br /> Resolution: San Joaquin County EHD <br /> (Please use the back of this sheet for additional comments or contac S fla"24 3 5 7 4 0 <br /> iv 04125/2024 07:31:19 <br /> f Ililll'llSTK2lEll�llllllll <br /> STK24Zg74 <br /> 0 <br />
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