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WP0041268 (2)
Environmental Health - Public
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VIA CASALINA
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041268 (2)
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Last modified
8/5/2021 3:56:08 PM
Creation date
7/6/2021 2:55:13 PM
Metadata
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Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041268
PE
4366
STREET_NUMBER
29639
Direction
E
STREET_NAME
VIA CASALINA
STREET_TYPE
PKWY
City
ESCALON
Zip
95320-
APN
18740054
ENTERED_DATE
9/24/2020 12:00:00 AM
SITE_LOCATION
29639 E VIA CASALINA PKWY
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_12-3.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> i ���5 <br /> Inter-L story Condition Upon Receipt (Attach to COC) ✓� ir <br /> Sample Receipt at: ST CC CH VI <br /> 1. Number of ice chests/packages received: Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps: 13 / / / / <br /> Surface water SWTR bact samples: A sample that has a temperature upon receipt of >I0'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.) Ye No <br /> 5. VOAs checked for Headspace? Y No N/ <br /> 6. Were sample custody seals intact? Yes No <br /> 7. If required, was sample split for pH analysis? $te <br /> No MN/ <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date,time and sampler name No <br /> Sign and date the COC,place in a ziplock and put in the ame ice chest amples. <br /> Sample Receipt Review completed by (initials): ll <br /> Sample Receipt at SP: /J J <br /> 1. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 6U C. If many ckages are received t one time check for tes /H.T.'s/rushes/ <br /> 2. Shipping trackin n rs: <br /> 3. Do the numb of bottles received agree with the CO ? 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 &A <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? oe No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No NW FGL <br /> [Exception:Oil&Grease,VOA and CM verified in lab] <br /> 4. VOAs checked for Headspace? ) No N/A <br /> 5. Have rush or project due dates been checked and accepted? s No I <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: 7�e <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 <br /> nitiated By: San Joaquin County ContCacted: (3017919) EHD <br /> Problem: STRI36695 <br /> Resolution: <br /> iv 0511212021 16:38:26 here <br /> (Please <br /> )se the back of this sheet for additic <br /> contacts) <br /> IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII <br />
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