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SR0083744_SSNL
Environmental Health - Public
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2600 - Land Use Program
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SR0083744_SSNL
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Entry Properties
Last modified
6/21/2021 2:36:59 PM
Creation date
6/21/2021 2:30:13 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0083744
PE
2602
FACILITY_NAME
LEVENTINI SHOUP / SACO PROERTY
STREET_NUMBER
23110
Direction
N
STREET_NAME
DUSTIN
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
00705013
ENTERED_DATE
5/21/2021 12:00:00 AM
SITE_LOCATION
23110 N DUSTIN RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\tsok
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EHD - Public
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/4,97 <br />No <br />No <br />No (---EZMFGL <br />No <br />No <br />No <br />N/A <br />N/A <br />FGL Environmental <br />Revision Date: 10/09/14 <br />Doc ID: 3D0900002_SOP_12.DOC <br />Page 1 of 1 <br />Inter-L ory Condition Upon Receipt (Attach to COC) 4/34338 <br />Sample Receipt at: CC CH VI <br />1. Number of ice ches s packages received: / Shipping tracking # <br />2.0 4. Were samples received in a chilled condition? Temps: J. / I / / <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 />Do the number of bottles received agree with the COC? <br />Were samples received intact? (i.e. no broken bottles, leaks etc.) <br />VOAs checked for Headspace? <br />Were sample custody seals intact? <br />Yes <br />If required, was sample split for pH analysis? <br />Were all analyses within holding times at time of receipt? <br />Verify sample date, time and sampler name <br />Sign and date the COC, place in a ziplock and put in t <br />Sample Receipt Review completed by (initials): <br />Sample Receipt at SP: <br />1. Were samples received in a chilled condition? Temps: 3, , , , <br />Acceptable is above freezing to 6 C. If many ackages are received at on ime check for tests/H.T.'s/ru <br />2. Shipping tracking munbers: <br />Do th umber of bo les receiv d agree with the COC? No N/A <br />Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br />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 />Were all requested analyses understood and acceptable? <br />Did bottle labels correspond with the client's ID's? <br />Were all bottles requiring sample preservation properly preserved? <br />[Exception: Oil & Grease, VOA and CrVI verified in labl <br />VOAs checked for Headspace? <br />Have rush or project due dates been checked and accepted? <br />Were all analyses within holding times at time of receipt? <br />Attach labels to the containers and include a copy of the CO <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: <br />Problem: <br />Resolution: <br /> <br />Dl-srvrsta, <br /> <br />(3016601) <br />Live Oak Geo Environmental <br />SIK2134381 <br /> <br />(Please use the back of this sheet for additional a <br />contacts) <br /> <br />No N/A <br />No <br />No <br />No <br />No <br />No <br />No <br />ame ice chest as the samples. <br />N/A <br />("ie-g) <br />Yes
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