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ARCHIVED REPORTS_2014_4
Environmental Health - Public
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ARCHIVED REPORTS_2014_4
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Last modified
7/18/2020 4:16:35 PM
Creation date
7/3/2020 10:57:59 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4400 - Solid Waste Program
File Section
ARCHIVED REPORTS
FileName_PostFix
2014_4
RECORD_ID
PR0440005
PE
4433
FACILITY_ID
FA0004516
FACILITY_NAME
FORWARD DISPOSAL SITE
STREET_NUMBER
9999
STREET_NAME
AUSTIN
STREET_TYPE
RD
City
MANTECA
Zip
95336
APN
20106001-3, 5
CURRENT_STATUS
01
SITE_LOCATION
9999 AUSTIN RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\SW\SW_4433_PR0440005_9999 AUSTIN_2014_4.tif
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EHD - Public
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FGL Environmental <br />Revision Date: 11/18/13 <br />Doc M: 3D0900002_SOP_10.DOC <br />Page 1 of i <br />inter-Ltory Condition Upon Receipt (Attach <br />Sample Receipt at: TK CC CH VY <br />1. Number of ice ch packages received: / Shipping tracking # <br />2. Were samples received in a chilled condition? Temps: IZ&d—1 / / <br />Surface water SVrM tact samples: A sample that has a temperature upon receipt of a10° C, whether iced or not, <br />should be flagged unless the time since sample collection has been less than two hours. <br />to COC) /���. <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.) I& No <br />S. VOAs checked for Headspace? Yes No <br />6. Were sample custody seals intact? Yes No <br />7. If required, was sample split for pH analysis? Y No /A <br />8. Were all analyses within holding times at time of receipt? 9P No <br />9. Verify sample date, time sampler �' No <br />' <br />Sip and date the COC, place in a ziplock and pu e 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: 3 / 4 / <br />Acceptable is above fivezing to 6° C. If rrreny packages are received at one time check for tests/H.T.'s/rushes/ <br />2. Shi'p11ping tracking nyru�m�be : <br />V'Vo� Ji(tt�'�"If1W'VtS/�1�J�Jd'7`7 r ��W�U�7 lJ� <br />3. Do the number of bottles received agree with the COC? Y No N/A <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.)No <br />5. Were sample custody seals intact? �ffNo N/A <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? No N/A FGL <br />4. VOAs checked for Headspace? No <br />5. Have rush or project due dates been checked and accepted? Yes No <br />Attach Iabels to the containers and include a copy of the COC for lab ry. <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: <br />Initiated By <br />Problem: <br />Resolution: <br />(Please use the back of this sheet for additional comm <br />contacts) <br />Phone Number. <br />(3-8692) <br />FOf ward Inc, eel <br />STK1436562 <br />IV -07/03/2014-11:42:09 <br />
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