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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: M8/13 <br />Doc M: 3D0900002 SOP 10MOC <br />Page 1 of 1 <br />0 Inter -La tory Condition Upon Receipt Attach to CO �'OY54,6 <br />Pc � <br />Sample Receipt at: a ilk 1 CC CH VI' <br />1. Number: of ice chmWackages received: _Shipping tracking # <br />2. Were samples received in a chilled condition? Temps: AW/ / / ! <br />Surface water SWTR tact samples: A sample that has a temperature upon receipt of >100 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? Yes No <br />6. Were sample custody seals intact? Yes No <br />7. 1f required, was sample split for pH analysis? Yes No <br />8. Were all analyses within holding times at time of receipt? No <br />9. Verify sample date, time sampler gNo <br />Sign and date the COC, place in a zipiock and put hr <br />same ' 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: 5-/ 5—, <br />Acceptable is above freezing to 6° C. If many packages are received at one time checkfor r testslli T.'shuZe—d <br />2. Shipping cracking numbers: 'f ",1 001070q7*n— _c 'D1 <br />0 <br />010%o 694'0 3X <br />3. Do the number of bottles received agree with the COC?Y No N/A <br />4. Were sample's received intact? (i.e. no broken bottles, leaks etc.) No <br />5. Were sample custody seals intact? No 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? 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(S FGL <br />4. VOAs checked for Headspace? Yes No <br />5. Have rush or project due dates been checked and accepted? Yes No <br />Attach labels to the containers and include a copy of the COC for lab d 'v <br />Sample Receipt,:and Verification completed by (initials): <br />Discrepancy Documentation: <br />Any items above which are `Wo" 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: Phone Number: <br />Initiated By, (3-8692) <br />Problem: Forward Inc <br />Resolution: <br />(Please use the back of this sheet for additional commen STK 14 3 5 6 6 <br />contacts) IV -08/22/2014-12:55:32 <br />
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