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WP0044683
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0044683
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Entry Properties
Last modified
2/12/2024 10:58:25 AM
Creation date
1/24/2024 4:09:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0044683
PE
4366
STREET_NUMBER
184
Direction
E
STREET_NAME
HARNEY
STREET_TYPE
LN
City
LODI
Zip
95242-
APN
05805003
ENTERED_DATE
7/11/2023 12:00:00 AM
SITE_LOCATION
184 E HARNEY LN
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 Con i i pon Receipt (Attach to COC) �'- <br /> Sample Receipt at: CC CH ST VI <br /> 1. Number of ice chests/packages receiv Shipping tracking#(s): <br /> 2. Temp IR Gun ID #UJ <br /> 3. Were samples received on ice? Yes No Temps�F <br /> Surface water SWTR bact samples:A 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 etc.) No <br /> 6. VOAs checked for Headspace? XENo N/A <br /> 7. Were all analyses within holding times at time of receipt? No <br /> 8. Verify sample date,time and sampler name Yes No <br /> Sign and date the COC,place in a ziplock and put in the ame ice chest as t e samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Number of ice chests/packages received: Z. Shipping tracking#(s): �5Coc)-Jbl�l <br /> �Coo�1�ZtSO <br /> 2. Temp IR Gun ID#: <br /> 3. Were samples received on ice? es No Temps: o• <br /> Acceptable is above freezing to 6°C. If many 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? ne No N/A <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc.) es 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? ae 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 /A F G L <br /> [Exception:Oil&Grease,VOA and CrVI verified in labl <br /> 4. VOAs checked for Headspace? es No N/A <br /> 5. Have rush or project due dates been checked and accepted? Yes No N/ <br /> 6. Were all analyses within holding times at time of receipt? (n) 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: - T)ate- <br /> Problem: (3017919) <br /> Resolution: San JoaquinCounty END <br /> (Please use the back of this sheet for additional comments or contac, STIQ430812 <br /> jaw 011121202416:35:38 <br /> 1111011111111111111111 <br /> STK2430912 <br />
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