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WP0040962
Environmental Health - Public
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4300 - Water Well Program
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WP0040962
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Last modified
6/7/2021 1:58:28 PM
Creation date
6/7/2021 1:36:01 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0040962
PE
4366
STREET_NUMBER
7125
Direction
E
STREET_NAME
SEDAN
STREET_TYPE
AVE
City
MANTECA
Zip
95337-
APN
22610018
ENTERED_DATE
7/10/2020 12:00:00 AM
SITE_LOCATION
7125 E SEDAN AVE
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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FGL Environmental Doc ID: 3D0900002_SOP_12-3.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 I <br /> Inter-L tory Condition Upon Receipt (Attach to <br /> Sample Receipt at: STK CC CH VI <br /> 1. Number of ice the s packages received: Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps: <br /> Surface water SWTR bact samples:A sample that has a temperature upon receipt of >10'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? No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) 5 No <br /> 5. VOAs checked for Headspace? Yes No <br /> 6. Were sample custody seals intact? Yes No <br /> 7. If required, was sample split for pH analysis? Ye& No <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date, time and sampler name Yes No <br /> Sign and date the COC,place in a ziplock and put in the a ice chest 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 6- C. If many packages are received at one time c eck for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: !t U <br /> 3. Do the number of bottles received agree with the COC? 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 NSA``` <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? e No <br /> 3. Were all bottles requiring sample preservation properly preserve Yes No N/A FGL <br /> ]Exception:Oil&Grease,VOA and CM verified in lab] <br /> 4. VOAs checked for Headspace? Yes No <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? C': es, No <br /> Attach labels to the containers and include a copy of the COCo very. <br /> Sample Receipt, Login and Verification completed by (initial <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 /> San Joaquin r � <br /> Problem: q County EHO <br /> Resolution: <br /> STK2135321 <br /> (Please use the back of this sheet for additional c apb 04/20/2021 16:24:54 <br /> contacts) IIIIIIIIIIIIIIIIIIIIIIIIIIIII�IIIIIIIIII <br />
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