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SU0010312_SSNL
Environmental Health - Public
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EHD Program Facility Records by Street Name
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99 (STATE ROUTE 99)
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18915
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2600 - Land Use Program
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PA-1400235
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SU0010312_SSNL
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Last modified
11/19/2024 1:52:19 PM
Creation date
9/8/2019 12:54:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0010312
PE
2622
FACILITY_NAME
PA-1400235
STREET_NUMBER
18915
Direction
N
STREET_NAME
STATE ROUTE 99
City
ACAMPO
APN
01322016
ENTERED_DATE
12/1/2014 12:00:00 AM
SITE_LOCATION
18915 N HWY 99
RECEIVED_DATE
12/1/2014 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\N\HWY 99\18915\PA-1400235\SU0010312\SS STDY.PDF
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EHD - Public
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FGL Environmental Doc ID: 3DO900002_SOP_12.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-L atory Condition Upon Receipt (Attach to COC) 111-`0" <br /> Sample Receipt at: STK CC CH V1 <br /> 1. Number of ice ches s packages received: / Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps: AW/ / /_the / <br /> Surface water S WTR batt samples:A sample that has a temperature upon receipt of ;lo°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? No N/A <br /> 4. Were samples received intact?(i.e. no broken bottles, leaks etc.) No <br /> 5. VOAs checked for Headspace? we No N/A <br /> 6. Were sample custody seals intact? YesNot� <br /> 7. If required, was sample split for pH analysis? Yrs No <br /> S. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date, time and sampler name No <br /> Sign and date the COC, place in a ziplock and pu same ice chest as the samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 0-G- If manypackages are received at one time check for tests/Ft T's/rushsst- --._. .__. <br /> 2. Shipping tracking numbers: I „ „ W M�/'' <br /> 3. Do the number of bottles received agree with the COC? 1 No N/A <br /> 4. Were samples received intact?(i.e. no broken bottles, leaks etc.) No <br /> 5. Were sample custody seals intact? Mt <br /> No N/A <br /> Sign and date the COC, obtain LIMS sample numbers, select methods/terint labels. <br /> Sample Verification, Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? 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 NoN/A FGL <br /> lEzcepnon:Oil&Grease,VOA and CM verified in lab] <br /> 4. VOAs checked for Headspace? es No <br /> 5. Have rush or project due dates been checked and accepted? Yes No C <br /> 6. Were all analyses within holding times at time of receipt? e No <br /> Attach labels to the containers and include a copy of the COC forlab deli <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: (3-16608) <br /> Initiated By: Live Oak Geo Environmental <br /> Problem: <br /> Resolution: STI{1 4 5151 1 <br /> (Please use the back of this sheet for additional com IV-11/12/2014-12:48:48 ere <br /> contacts) — <br />
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