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SU0011568 SSNL
Environmental Health - Public
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SU0011568 SSNL
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Last modified
5/7/2020 11:35:15 AM
Creation date
9/4/2019 6:08:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0011568
PE
2622
FACILITY_NAME
PA-1700252
STREET_NUMBER
13822
Direction
S
STREET_NAME
ESCALON BELLOTA
STREET_TYPE
RD
City
ESCALON
Zip
95320-
APN
20732009
ENTERED_DATE
11/6/2017 12:00:00 AM
SITE_LOCATION
13822 S ESCALON BELLOTA RD
RECEIVED_DATE
11/3/2017 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\E\ESCALON BELLOTA\13822\PA-1700252\SU0011568\SS STUDY .PDF
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EHD - Public
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FGL Environmental Doc ID: 3DO900002 SOP12.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 _ <br /> Inter-Lays tory Condition Upon Receipt (Attach to COC) /7J� 5j <br /> • Sample Receipt at: TK CC Cg VI <br /> 1. Number of ice chests/packages received: I Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps: <br /> Surface water SWIM bact samples: A sample 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 /> 3. Do the number of bottles received agree with the COC? C No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) Cies' No <br /> 5. VOAs checked for Headspace? No N/A <br /> 6. Were sample custody seals intact? Yes No 60P <br /> 7. If required, was sample split for pH analysis? Yes No <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date, time and sampler name Yes No <br /> Sign and date the COC,place in a ziplock and put in the same ice chest as the samples. <br /> Sample Receipt Review completed by(initials):_1=k <br /> Sample Receipt at SP: <br /> I. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 04 C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: <br /> 53�—/ SC.p-� q co% 55� <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.) Je3 No <br /> 5. Were sample custody seals intact? Yes No N/ <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? es No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No � FGL <br /> [Exception:Oil&Grease,VOA and CrVI verified in Iabl <br /> 4. VOAs checked for Headspace? es NoC-{C <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? es 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): G-)C <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: <br /> Initiated By: (3-16608) <br /> • Problem: Live Oak Geo Environmental <br /> Resolution: <br /> STK1752355 <br /> (Please use the back of this sheet for additional comments I CTC-09/26/2017-16:38:13 <br /> contacts) <br />
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