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WP0039949
Environmental Health - Public
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4300 - Water Well Program
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WP0039949
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Last modified
6/7/2021 1:56:11 PM
Creation date
6/7/2021 1:32:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0039949
PE
4370
STREET_NUMBER
19465
Direction
S
STREET_NAME
CARROLTON
STREET_TYPE
AVE
City
RIPON
Zip
95366-
APN
24538049
ENTERED_DATE
8/13/2019 12:00:00 AM
SITE_LOCATION
19465 S CARROLTON AVE
P_LOCATION
05
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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FGL Environmental Doc ID: 3DO900002_SOP_12.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter- tory Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at: STK CC CH VI <br /> 1. Number of ice:a <br /> packages received: Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps: 12,� / / / <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? es No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc No <br /> 5. VOAs checked for Headspace? Yes No <br /> 6. Were sample custody seals intact? Yes N <br /> 7. If required, was sample split for pH analysis? N <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_1be same ice ches as t e samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temp <br /> Acceptable is above freezing to 60 C. If many packages are received t gpe time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: <br /> bl` <br /> 3. Do the number of bottles received agree with th COC? C°4e9-'S No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) es No <br /> 5. Were sample custody seals intact? Yes No <,—M!) <br /> Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print labels. <br /> Sample Verification, Labeling and Distribution: <br /> I. Were all requested analyses understood and acceptable? e No <br /> 2. Did bottle labels correspond with the client's ID's? No <br /> 3. Were all bottles requiring sample preservation properly preserved es' No N/A FGL <br /> [Exception:Oil&Grease,VOA and CM verified in labl <br /> 4. VOAs checked for Headspace? Yes No <br /> 5. Have rush or project due dates been checked and accepted? Yes No (775 <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 f d t <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: <br /> Initiated By: (3017919) <br /> Problem: San Joaquin County EHD <br /> Resolution: 4147 <br /> STK2 3 <br /> (Please use the back of this sheet for additional coma iv 0313012021 15:49:34 <br /> contacts) III IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII <br />
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