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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
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\4200 - Liquid Waste\V\VIA NICOLO\17950\PR0521836\MONIT RPTS.PDF
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EHD - Public
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FGL Environmental Doc ID:3D0900002_SOP_12-44.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-Lary Condition Upon Receipt (Attach to COC) f J�Jc2 J�IP <br /> Sample Receipt at'. S /{ CC r CH VI <br /> 1. Number of ice c s packages received: Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps: Rtv:�/ / / / <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.) 5 No <br /> 5. VOAs checked for Headspace? � No N/A <br /> 6. Were sample custody seals intact? Yes No <br /> 7. If required,was sample split for pH analysis? No /A <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date, time and sampler name No <br /> Sign and date the COC,place in a ziplock and put in a ame 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 6.h C. If many packages are received atone time check for tests/H.T.'stnishes/ ' <br /> 2. Shipping tracking numbers: ri [ 0 2!I L1`V Y7� �? <br /> D JV <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.) e No <br /> 5. Were sample custody seals intact? es 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: I V <br /> 1. Were all requested analyses understood and acceptable? es 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 N/A FGL <br /> [Exception:Oil&Grease,VOA and CrVl verified in lab] <br /> 4. VOAs checked for Headspace? es No N/A <br /> 5. Have rush or project due dates been checked and accepted? No <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 COC for lab deli <br /> Sample Receipt, Login and Verification completed by(initials): ry <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: (3-11544) <br /> Problem: 11usco Family Olive Dviromiental <br /> Resolution: <br /> STK1552366 <br /> (Please use the back of this sheet for additional commel <br /> contacts) Tv-11!nv/2 15- a:29:41 <br />
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