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SR0082764_SSNL
Environmental Health - Public
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SR0082764_SSNL
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Entry Properties
Last modified
11/30/2020 8:28:42 AM
Creation date
11/30/2020 8:17:16 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0082764
PE
2602
FACILITY_NAME
24320 S FREDERICK AVE
STREET_NUMBER
24320
Direction
S
STREET_NAME
FREDERICK
STREET_TYPE
AVE
City
RIPON
Zip
95366
APN
25726011
ENTERED_DATE
10/21/2020 12:00:00 AM
SITE_LOCATION
24320 S FREDERICK AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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FGL Environmental Doc ID: 3DO900002 SOP 12-1.DOC <br /> Revision Date: 0/09/14 Page 1 oi'1 <br /> Inter-L ory C )ndition Upon Receipt (Attach to COC) 7 <br /> Sample Receipt at: STK CC CH VI <br /> 1. Number of ice chests packages re eived: Shipping tracking# <br /> 2. Were samples received in a chille, condition? Temps: 7 00 <br /> Surface water SWTR bact samples: A si nple that has a temperature upon receipt of >10°C,whether iced or not, <br /> should be flagged unless the time since sample ollection has been less than two hours. <br /> 3. Do the n ber of bottles receives agree with the COC? No N/A <br /> 4. Were samples received intact?(i. . no broken bottles, leaks etc.) No <br /> 5. VOAs checked for Headspace? No N/A <br /> 6. Were sample custody seals intact Yes No <br /> 7. If requirep, was sample split for 1 analysis? ypz No <br /> 8. Were all alyses within holding imes at time of receipt? No <br /> 9. Verify sainple date, time and sar pier name Yes No <br /> Sign and date tie COC, place in a zipl( zk and put in t ame ice chest as the samples. <br /> Sample Receipt Review completed by initials): <br /> Sample Receipt at SP: <br /> 1. Were sariiples received in a chills I condition? Temps: <br /> Acceptable is above freezing to 6-5, C. t•many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: <br /> 3. Do the n ber of bottles receive. agree with the COC? No N/A <br /> 4. Were sariples received intact? (i. . no broken bottles, leaks etc.) ZEeDs No <br /> 5. Were sample custody seals intact ' Yes No 1/ <br /> Sign and date e COC, obtain LIMS s mple numbers, select methods/tests and print labels. <br /> Sample Verif ation, Labeling and 1 stribution: <br /> 1. Were all Fequested analyses unde stood and acceptable? No <br /> 2. Did bottl labels correspond witl the client's ID's? No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No FGL <br /> lException: til&Grease,VOA and CM verified in labl <br /> 4. VOAs cl ecked for Headspace? <!��s No N/A <br /> 5. Have rus or project due dates bt •n checked and accepted? Yes No N/ <br /> 6. Were all analyses within holding imes at time of receipt? e';'>'j No <br /> Attach labels t the containers and inc Ide a copy of the COC for lab delivery. <br /> Sample Receir t, Login and Verificatio i completed by (initials):I <br /> Discrepancy ocumentation: <br /> Any items above which are "No"or d( not meet specifications (i.e. temps) must be resolved. <br /> 1. Person ontacted: Phone Number: <br /> Initiated y: Date: <br /> Problem <br /> Resoluti n: r <br /> 2. Person ontacted: <br /> 11114vL :\V v11N1 <br /> Initiated y: <br /> Problem n <br /> �,J ii\vYJ � J ZJ I <br /> Resoluti n: <br /> (Please use the back of this sheet for a ditional comm( re <br /> contacts) -- <br />
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