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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
Scanner
SJGOV\tsok
Tags
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 <br /> Inter-La hAXA.atory Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at: T CC CH VI <br /> 1. Number of ice ches s packages received: / Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps: /pp <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.) Y No <br /> 5. VOAs checked for Headspace? No N/ <br /> 6. Were sample custody seals intact? Yes No <br /> 7. If required, was sample split for pH analysis? Yes No <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date,time and sampler nameYes 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: 1< z�; <br /> 1. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 6U C. If many pa ages are received at o e time check for tests .T.'s/rushes/ <br /> 2. Shipping tracki numbers;., <br /> 3. Do th�el ero ttles received agr e with the COC? 1 o N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) s 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? e No <br /> 2. Did bottle labels correspond with the client's ID's? es No <br /> 3. Were all bottles requiring sample preservation properly preserved? s No /A FGL <br /> [Exception:Oil&Grease,VOA and CrVI verified in labl <br /> 4. VOAs checked for Headspace? � No Nom/ <br /> 5. Have rush or project due dates been checked and accepted? Yes No C�1 <br /> 6. Were all analyses within holding times at time of receipt? s No <br /> Attach labels to the containers and include a copy of the COC for lab de <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: STU136228 <br /> ere <br /> (Please use the back of this sheet for addition apb 0510612021 16:52:47 <br /> .•contacts) VIII II IIII III III II II I II IIII <br /> M2136228 <br />
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