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WP0041971
Environmental Health - Public
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4300 - Water Well Program
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WP0041971
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Entry Properties
Last modified
6/7/2021 1:54:42 PM
Creation date
6/7/2021 1:37:32 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0041971
PE
4380
STREET_NUMBER
19025
Direction
E
STREET_NAME
ALLEN
STREET_TYPE
RD
City
RIPON
Zip
95366-
APN
24538020
ENTERED_DATE
4/26/2021 12:00:00 AM
SITE_LOCATION
19025 E ALLEN RD
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: 10/09/14 Page 1 of 1 <br /> A <br /> Inter-L tory Condition Upon Receipt (Attach to COC) /.3��a yit <br /> Sample Receipt at: TK CC CH VI <br /> 1. Number of ice ch packages received: f Shipping tracking # <br /> G <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 >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? No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) ENO <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 /A <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date, time and sampler name Ye No <br /> Sign and date the COC, place in a ziplock and put in t �s e jce chest as the 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 p ckages are received at a time check for tests/H.T.'s/rushes/ <br /> 2. Shi)])M* g tra in nu e rn� <br /> )lV <br /> V <br /> 3. Do the num er of bottles received agree with the COC? Ye 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 <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? es No <br /> 2. Did bottle labels correspond with the client's ID's? s No <br /> 3. Were all bottles requiring sample preservation properly preserved? es No N/A FGL <br /> IException: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 / <br /> 6. Were all analyses within holding times at time of receipt? � No <br /> Attach labels to the containers and include a copy of the COC for lab delivery. <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: (3017919) D <br /> Initiated By: San Joaquin County EH <br /> Problem: STK2136290 <br /> Resolution: <br /> IIIIII 11 <br /> (Please use the back of this sheet for addit. apb 0510612021 16. !r hereIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII <br /> contacts) <br />
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