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SR0082357 SSNL
Environmental Health - Public
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2600 - Land Use Program
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SR0082357 SSNL
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Last modified
8/17/2020 5:16:16 PM
Creation date
8/17/2020 3:11:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0082357
PE
2602
FACILITY_NAME
JIMENEZ PROPERTY
STREET_NUMBER
124
Direction
W
STREET_NAME
BRIGGS
STREET_TYPE
RD
City
LATHROP
Zip
95330
APN
1933037
ENTERED_DATE
7/22/2020 12:00:00 AM
SITE_LOCATION
124 W BRIGGS RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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FGL Environmental Doc ID:3D0900002_SOP_12-14.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-L to7(C <br /> Condition Upon Receipt (Attach to COC) 4 ��U <br /> Sample Receipt at: STK r CH VI <br /> 1. Number of ice c es packages received: f Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps:9l U / / / / <br /> Surface water SWTR bact samples:A sample that has a temperature upon receipt of >101 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? e No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks et . Yes No <br /> 5. VOAs checked for Headspace? No NZA <br /> 6. Were sample custody seals intact? Yes No A <br /> 7. If required, was sample split for pH analysis? s N <br /> 8. Were all analyses within holding times at time of receipt? es 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 me ice ches pies. <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"C. if many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: V J CA-A <br /> 3. Do the number of bottles received agree with the COC? ®e No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) eD No <br /> 5. Were sample custody seals intact? Yes No ?/ <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? es No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No FGL <br /> [Exception:Oil&Grease,VOA and CrVI 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 N/A <br /> 6. Were all analyses within holding times at time of receipt? �se No <br /> Attach labels to the containers and include a copy of the COC for lab delivery. <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: Phnne.Number:---- --_ _ <br /> Initiated By: (3-16608) <br /> Problem: Dive Oak Geo Ehviromental <br /> Resolution: <br /> (Please use the back of this sheet for additional comment STK 2®3 8 7 8 8 <br /> contacts) APB-06/22/2020-16:04:17 <br />
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