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SU0004627_SSNL
Environmental Health - Public
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EHD Program Facility Records by Street Name
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12 (STATE ROUTE 12)
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2600 - Land Use Program
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PA-0400488
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SU0004627_SSNL
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Last modified
11/19/2024 3:46:24 PM
Creation date
9/9/2019 10:23:32 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0004627
PE
2622
FACILITY_NAME
PA-0400488
STREET_NUMBER
11456
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
APN
02506003
ENTERED_DATE
9/2/2004 12:00:00 AM
SITE_LOCATION
11456 W HWY 12
RECEIVED_DATE
9/2/2004 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Supplemental fields
FilePath
\MIGRATIONS\T\HWY 12\11456\PA-0400488\SU0004627\SS STDY.PDF
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EHD - Public
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LFGL Environmental Doc ID: <br /> F3REC005.002 <br /> Revision Date: 01/20/04 Page: 1 of 1 <br /> L Stockton - Condition Upon Receipt (Attach to COC) <br /> L Sample Receipt at STK: <br /> L Number of ice chests/packages received: <br /> L 2. Were samples received in a chilled condition? Temps: / <br /> Acceptable is above freezing to 6°C. Also acceptable is received on ice(ROI)for the same day of sampling or <br /> received at room temperature(RRT)if sampled within one hour of receipt. Client contact for temperature failures <br /> must be documented below. If many packages are received at one time check for tests/H.T.'s/rushes/Bacti's to <br /> Lprioritize furtber review. Please notify Microbiology personnel immediately of bacti samples received.. <br /> 3. Do the number of bottles received agree with the COC? es No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) es No <br /> 5. Were sample custody seals intact? /A , Yes No <br /> Sign and date the COC,place in a ziplock and put in the same ice chest as e B pies. <br /> Sample Receipt Review completed by(initials): / <br /> Sample Receipt at SP: <br /> L1. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 6°C. If many packages are received at one time check for tests/H.T.'shusbes/Bacti's to <br /> prioritize fmtber review. Please notify Microbiology personnel immediately of bacti samples received. <br /> L 2. Do the number of bottles received agree with the COC? E:No <br /> o N/A <br /> L 3. Were samples received intact? (i.e. no broken bottles,leaks etc.) <br /> 4. Were sample custody seals intact? es No <br /> LSign and date the COC, obtain LIMS sample numbers, select methods/tests and print labels. <br /> Sample Verification,Labeling and Distribution: <br /> L 1. Were all requested analyses understood and acceptable? 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 /> L <br /> 4. Were all analyses within holding times at time of receipt? YL No <br /> 5. Have rush or project due dates been checked and accepted? 4 Yes No <br /> 6. Attach labels to the containers and include a copy of the COC for lab delivery. <br /> LSample Receipt,Login and Verification completed by (initials): 61e4-- <br /> Discrepancy Documentation: <br /> Any items above which are "No" or do not meet specifications (i.e. temps)must be resolved. <br /> Ll. Person Contacted: Phone Number: <br /> Initiated By: Date: _ <br /> Problem: <br /> L (3-9574) <br /> Resolution: Neil Anderson & Associates <br /> L STK0650838 <br /> 1V-12/15/2006-11:25:43 <br /> L <br />
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