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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 1D: 3DO900002_SOP_12.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter- atory Condition Upon Receipt (Attach to COC) �� � i <br /> Sample Receipt a • ST CC CH VI <br /> 1. Number of ice ests/packages received: f Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps: 104, <br /> Surface water SWTR bact samples:A sample that has a temperature upon receipt of >I 0*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? <br /> 04ko N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks eto <br /> 5. VOAs checked for Headspace? o N/A <br /> 6. Were sample custody seals intact? Yes N <br /> 7. If required, was sample split for pH analysis? <br /> 8. Were all analyses within holding times at time of receipt? o <br /> 9. Verify sample date, time and sampler name o <br /> Sign and date the COC,place in a ziplock and put in tJA same i e 4ches as a 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 60 C. If many packages are recei ed at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: <br /> F)T L-7 <br /> 3. Do the number bo es received agree wit e COC? es No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) Yes 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 Labe s. <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? Ye No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No ® FGL <br /> [Exception:Oil&Grease,VOA and CrV1 verified in labl <br /> 4. VOAs checked for Headspace? <::: No N/A <br /> 5. Have rush or project due dates been checked and accepted? Yes 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 fr b ry. <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: Phone NST,,..--L- <br /> Initiated By: (3017919) D <br /> Problem: San Joaquin County EH <br /> Resolution: M213416 <br /> (Please use the back of this sheet for additional con iv 031301202115-.49-.55 <br /> contacts) IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII <br />
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