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COMPLIANCE INFO_10/7/24 SITE CHARACTERIAZTION RPT
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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4400 - Solid Waste Program
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PR0504909
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COMPLIANCE INFO_10/7/24 SITE CHARACTERIAZTION RPT
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Entry Properties
Last modified
10/25/2024 11:10:33 AM
Creation date
10/25/2024 9:52:15 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4400 - Solid Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
10/7/24 SITE CHARACTERIAZTION RPT
RECORD_ID
PR0504909
PE
4430 - SOLID WASTE CIA SITE
FACILITY_ID
FA0006400
FACILITY_NAME
RIVERBANK CITY DUMP
STREET_NUMBER
0
STREET_NAME
SANTA FE
STREET_TYPE
RD
City
RIVERBANK
Zip
95367
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
Site Address
SANTA FE RD RIVERBANK 95367
Tags
EHD - Public
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"ryryeffidr I*'.J <br />{:hi I f{Al.t:Y <br />SAMPTE RECEIPT CHECKLIST <br />1: General lnfo <br />Date Receivea: Y-Zo -24 wo*Client (**n <br />Section 2: Shipping / Custody <br />Custody seals intact on arrival? E ru/n E yes E lrto <br />Are custody seals present? E Yes <br />fl on cooler /box fI on samples <br />No <br />Shipping lnfo <br />E Outside 0.0 - 5.0"C (o.O <br />Type of ice used , (w"t <br />process had begun. (if checked, ski <br />- 10.0"C for microbiology) (PM notified) <br />E Blue/Gel E None <br />p temperatures) <br />E Sample matrix doesn't require cooling (e.g. air, bulk PCB). (if checked, skip temperatures) <br />lf no cooler: Observed/Adiusted Temo ("C): _l <br />coolerTemp ("c) or.S-*W"hr't--L-#3: / #4: <br />Thermometer/tRGun:7.07 cr: - A 3 <br />#5: /_#6: / _ <br />Section 3a: Condition / Packaging <br />Date opened Sfzzlz', By (initiat <br />(samnles received on ice directly from the field; cooling <br />Section 3b: Microbiology Samples <br />tr Within temp range 0.0 - 1O.O"C or received on ice directly from field <br />E Adequate headspace for microbiology analysis, <br />microbiology samples submitted (skip 3b) <br />E1.41 Canisters [ 5L Canisters ITedlar Bags E MCE Cassettes Otherfl SorbentTubes E <br />o air samples submitted (skip 3c)3c: Air Samples <br />Section 4: Containers / Labels / Samples YES NO N/A <br />1) Were custody papers present, filled properly, and legible? <br />2) ls the sampler's name present on the CoC? <br />3) were containers received in good condition (unbroken / unopened / uncompromised)? <br />4) Were the samples bagged? (required for microbiology samples; recommended for soil sa mples) <br />5) Were all of, and only, the correct samples received? <br />6) Are sample labels present, legible, and in agreement with the CoC? <br />7) Does the container count match the CoC?X <br />8) Was sufficient sample volume / mass received for the analyses requested? <br />9) Were samples received in proper containers for the analyses requested?x <br />10) Were samples received with > 1/2 holding time remaining?x <br />11) Are samples properly preserved as indicated by CoC / labels?X <br />L2) Unpreserved VOAs received - lf necessary, was the hold time changed in LIMS? <br />13) Are VOA vials free from headspace/bubbles > 6mm? <br />5: Explanations / Comments E PM notified <br />{/zz/zlZ/"aIT{ <br />aBy <br />By <br />Date Logged <br />Date Labeled <br />Enthalpy Analytical J-0006, Rev 2: Form Version 76.7087224 <br />XI <br />5 of 53
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