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ARCHIVED REPORTS_MONIT RPTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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VIA NICOLO
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17950
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4200 – Liquid Waste Program
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PR0521836
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ARCHIVED REPORTS_MONIT RPTS
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Last modified
12/4/2020 9:15:18 AM
Creation date
8/5/2020 10:11:57 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200 – Liquid Waste Program
File Section
ARCHIVED REPORTS
FileName_PostFix
MONIT RPTS
RECORD_ID
PR0521836
PE
4232
FACILITY_ID
FA0002971
FACILITY_NAME
MUSCO FAMILY OLIVE CO
STREET_NUMBER
17950
Direction
W
STREET_NAME
VIA NICOLO
City
TRACY
Zip
95377
APN
20911032
CURRENT_STATUS
01
SITE_LOCATION
17950 W VIA NICOLO
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\rtan
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FilePath
\MIGRATIONS\4200 - Liquid Waste\V\VIA NICOLO\17950\PR0521836\MONIT RPTS.PDF
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EHD - Public
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+ , a <br /> F'GL Environmental Doc ID: 1F3REC005.005 <br /> Revision Date: 1/13/49 Page: 1 of 1 <br /> Stockton - Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at STK: <br /> 1. Number of ice chests/packages received: f <br /> 2. Were samples received in u chilled condition? Temps: 1 1 I <br /> Acceptable is above freezing to 6°C. Also acceptable is received on ice(R41)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/rushesfBacti's to <br /> prioritize further review. Please notify Microbiology personnel inunediately of bac ' les received.. <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.) es No <br /> 5. VOAs checked for Headspace? Yes No <br /> 6. Were sample custody seals intact? Yes No / <br /> Sigh and date the COC. place in a ziplock and put in the same ice chest as th sa es. <br /> Sample Receipt Review completed by(initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition'? Temps:-I I I 1 <br /> Acceptable is above freezing to 6°C. If many packages are received at one time check for <br /> tests/H:r.'s/rushes/Racti's to prioritize further review. Please notify Microbiology personnel <br /> immediately of bacti samples received. <br /> 2. Do the number of bottles received agree with the COC? No N/A <br /> 3. Were samples received intact?(i.e.no broken bottles,leaks etc.) 0 No <br /> 4. Were sample custody seals intact? No NIA <br /> Sign and date the COC.obtain L1MS sample numbers,select methodsitests and print labels. <br /> Sample Verircation, 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? Y No <br /> 3. Were all bottles requiting sample preservation properly preserved? No N/A FGL <br /> 4. VOAs checked for Headspace? Ye No NIA <br /> 5. Were all analyses within holding times at time of receipt? No <br /> 6. 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 deli esz <br /> Sample Receipt,Login and Verification completed by(initials): <br /> Discrepancy Documentation: <br /> Any items above which arc"No"or do not meet specifications(i.e.temps)must be resolved. <br /> 1. Person Contacted' Vhnnw,VJJMhPr• <br /> Initiated By: (3n-11544) <br /> Problem: HuSCo Family Olive lhviromeental <br /> Resolution: <br /> STK1131330 <br /> IV--02/7.7/2011-13:05:36 <br />
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