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SR0081818
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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SR0081818
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Entry Properties
Last modified
3/16/2020 4:17:00 PM
Creation date
3/16/2020 2:13:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
FileName_PostFix
SSNL
RECORD_ID
SR0081818
PE
2602
FACILITY_NAME
LOPES PROPERTY
STREET_NUMBER
16520
Direction
W
STREET_NAME
VON SOSTEN
STREET_TYPE
RD
City
TRACY
Zip
95304
APN
20938052
ENTERED_DATE
2/28/2020 12:00:00 AM
SITE_LOCATION
16520 W VON SOSTEN RD
QC Status
Approved
Scanner
TSok
Tags
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 tory Condition Upon Receipt (Attach to COC) c 4421 YF r <br /> Sample Receipt at: STK CC CH VI <br /> 1. Number of ice chess packages received: _Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps: 9 9 / / / / <br /> Surface water SWTR batt 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.) Yes No <br /> 5. VOAs checked for Headspace? Yes No N/A <br /> 6. Were sample custody seals intact? Yes No <br /> 7. If required, was sample split for pH analysis? Y No N/ <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 e 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 ti cP23 -7 heck for tests/H.T.'�gushes/ <br /> 2. Shipping trackin numbers: �/ 11 �1 I <br /> 17 <br /> 3. Do the number�o ?otl receivi <br /> ed agree with the COC? No N/A <br /> g <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> 5. Were sample custody seals intact? Yes No <:SZN!S <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? No <br /> 2. Did bottle labels correspond with the client's ID's? Yes No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No <:1!E LIZ,� FGL <br /> [Exception:Oil&Grease,VOA and CrVI verified in labl <br /> 4. VOAs checked for Headspace? No N/A <br /> 5. Have tush or project due dates been checked and accepted? es No N/A <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 CO for ry. <br /> Sample Receipt, Login and Verification completed by (initia <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 /> Live Oak Geo Environmental <br /> Problem: _ <br /> Resolution: STK <br /> S TK 2031881 0318n1 <br /> (Please use the back of this sheet for additional commer IV-02../06/2020-15:36:59 <br /> contacts) <br />
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