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SR0082765_SSNL
Environmental Health - Public
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2600 - Land Use Program
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SR0082765_SSNL
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Entry Properties
Last modified
7/15/2021 9:25:09 AM
Creation date
11/23/2020 8:53:17 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0082765
PE
2602
FACILITY_NAME
21151 E SARA LN
STREET_NUMBER
21151
Direction
E
STREET_NAME
SARA
STREET_TYPE
LN
City
LINDEN
Zip
95236
APN
18336070
ENTERED_DATE
10/21/2020 12:00:00 AM
SITE_LOCATION
21151 E SARA LN
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\tsok
Tags
EHD - Public
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Sample Receipt Checklist <br />McCampbell Analytical, Inc.1534 Willow Pass Road, Pittsburg, CA 94565-1701 <br />Toll Free Telephone: (877) 252-9262 / Fax: (925) 252-9269 <br />http://www.mccampbell.com / E-mail: main@mccampbell.com"When Quality Counts" <br />Client Name:AdvancedGeo, Inc. <br />WorkOrder №:2012020 <br />Date Logged:12/1/2020 <br />Logged by:Lilly OrtizMatrix:Water <br />Carrier:Patrick Johnson (MAI Courier) <br />Shipping container/cooler in good condition?Yes No <br />Custody seals intact on shipping container/cooler?Yes No NA <br />Samples Received on Ice?Yes No <br />Chain of custody present?Yes No <br />Chain of custody signed when relinquished and received?Yes No <br />Chain of custody agrees with sample labels?Yes No <br />Samples in proper containers/bottles?Yes No <br />Sample containers intact?Yes No <br />Sufficient sample volume for indicated test?Yes No <br />NAAll samples received within holding time?Yes No <br />NASample/Temp Blank temperature <br />Yes No NAWater - VOA vials have zero headspace / no bubbles? <br />pH acceptable upon receipt (Metal: <2; Nitrate 353.2/4500NO3: <br /><2; 522: <4; 218.7: >8)? <br />Yes No NA <br />Temp:2.3°C <br />Chain of Custody (COC) Information <br />Yes NoSample IDs noted by Client on COC? <br />Yes NoDate and Time of collection noted by Client on COC? <br />Yes NoSampler's name noted on COC? <br />Sample Receipt Information <br />Sample Preservation and Hold Time (HT) Information <br />Sample labels checked for correct preservation?Yes No <br />Project:Hobman Property <br />(Ice Type:WET ICE ) <br />Comments: <br />pH tested and acceptable upon receipt (200.8: ≤2; 525.3: ≤4; <br />530: ≤7; 541: <3; 544: <6.5 & 7.5)? <br />Yes No NA <br />UCMR Samples: <br />Free Chlorine tested and acceptable upon receipt (<0.1mg/L)?Yes No NA <br />Date and Time Received:12/1/2020 14:40 <br />Received by:Lilly Ortiz <br />COC agrees with Quote?Yes No NA <br />Page 9 of 9
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