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SR0081180 SSNL
Environmental Health - Public
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SR0081180 SSNL
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Entry Properties
Last modified
1/28/2020 10:12:16 AM
Creation date
1/28/2020 10:04:35 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0081180
PE
2602
FACILITY_NAME
KUSALAKARI PROPERTY
STREET_NUMBER
9698
Direction
S
STREET_NAME
PRIEST
STREET_TYPE
RD
City
FRENCH CAMP
Zip
95231
APN
19322015
ENTERED_DATE
9/23/2019 12:00:00 AM
SITE_LOCATION
9698 S PRIEST RD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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FGL Environmental Doc ID: 3D0900002_SOP_12.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-La tory Condition Upon Receipt (Attach to COC) .5/30C� <br /> Sample Receipt at: STK CC CH VI <br /> 1. Number of ice ch!es packages received: f Shipping tracking # <br /> 2. Were samples received in a chilled condition? Temps: J <br /> Surface water SWTR 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? No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) FRe <br /> No <br /> 5. VOAs checked for Headspace? No N/A' <br /> 6. Were sample custody seals intact? Yes No t N <br /> 7. If required, was sample split for pH analysis? Y No <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date,time and sampler name eNo <br /> Sign and date the COC, place in a ziplock and put in the e 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 6s' C. if many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: �C5 11 C5-1 r <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? Yes No 4-0 <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? est No <br /> 2. Did bottle labels correspond with the client's ID's? s No <br /> 3. Were all bottles requiring sample preservation properly preserved? es No N/A FGL <br /> (Exception:Oil&Grease,VOA and CM verified in lab) <br /> 4. VOAs checked for Headspace? Ye ' No N/A <br /> 5. Have rush or project due dates been checked and accepted? es No N/A <br /> 6. Were all analyses within holding times at time of receipt? a 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)CJ4� <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: ili V°e vau vcv 1ALV ILWIlllcti+i,al <br /> Problem: <br /> Resolution: STK 19 513®6 <br /> (Please use the back of this sheet for additional comms APB-08/05/2019-07:38:58 re <br /> contacts) <br />
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