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WP0043538
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MICKE GROVE
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043538
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Entry Properties
Last modified
6/26/2024 11:12:37 AM
Creation date
6/5/2024 2:20:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043538
PE
4366
STREET_NUMBER
11250
Direction
N
STREET_NAME
MICKE GROVE
STREET_TYPE
RD
City
LODI
Zip
95240-
APN
05914069
ENTERED_DATE
7/27/2022 12:00:00 AM
SITE_LOCATION
11250 N MICKE GROVE RD
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 Con7: 11 <br /> Upon Receipt (Attach to COC) <br /> Sample Receipt at: CC CH VI <br /> 1. Number of ice chests/packages recei — Shipping tracking#(s): <br /> 2. Temp IR Gun ID#: 1 <br /> 3. Were samples received on isYes o Temps. 1 �, / / I / <br /> Surface water SWTR bact samples: a that has a temperature upon receipt of >l0'C,whether iced or not, <br /> should be flagged unless the time since sample collection has been less than <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. Yes No <br /> 6. VOAs checked for Headspace? Yes N <br /> 7. Were all analyses within holding times at time of receipt? No <br /> 8. Verify sample date,time and sampler name _ e No <br /> Sign and date the COC,place in a ziplock and put in t1w same ice ches a 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#: <br /> 3. Were samples received on ice? , e No Temps: <br /> Acceptable is above freezing to 6°C. If ny 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? Ze,� No N/A <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc.) Ycs- 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? es No <br /> 2. Did bottle labels correspond with the client's ID's? �� No <br /> 3. Were all bottles requiring sample preservation properly preserved? No N/A FGL <br /> [Exception:Oil&Grease,VOA and CM verified in lab] <br /> 4. V OAs checked for Headspace? Yes No %ILA <br /> 5. Have rush or project due dates been checked and accepted? Yes No N A <br /> 6. Were all analyses within holding times at time of receipt? YLe�v No <br /> Attach labels to the containers and include a copy of the COC forlab 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: <br /> Resolution: (3017919) <br /> San Joaquin CountyEHD <br /> (Please use the back of this sheet for additional comments or cont; STU437398 <br /> cda 0512312024 09:05:32 <br /> �l Ill Il�Ill�lllll Illlalalllll Il Ill <br /> CTY7dT7tOA <br />
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