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WP0041747
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041747
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Entry Properties
Last modified
8/11/2021 4:48:54 PM
Creation date
7/14/2021 9:14:56 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041747
PE
4369
STREET_NUMBER
133
Direction
W
STREET_NAME
JAHANT
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
00310027
ENTERED_DATE
3/1/2021 12:00:00 AM
SITE_LOCATION
133 W JAHANT RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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FGL Environmental Doc ID:3D0900002_SOP_12.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-La atonyCondition Upon Receipt (Attach to COC) <br /> Sample ReceiptCC CH VI <br /> 1. Number ofC=2kages received: _Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps: 5,�/ <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. No <br /> 5. VOAs checked for Headspace? Y No N/A <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? I No <br /> 9. Verify sample date,time and sampler name a No <br /> Sign and date the COC, place in a ziplock and put in a ice chest as the samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: 2 <br /> 1. Were samples received in a chilled condition? Temps: / ✓ / / / <br /> Acceptable is above freezing to 6A C. If many package a received at one time check or tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: <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 C'LT�A--N <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? <3M�i No <br /> 2. Did bottle labels correspond with the client's ID's? <ng�) No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No F G L <br /> [Exception:Oil&Grease,VOA and CrVI verified in labl <br /> 4. VOAs checked for Headspace? No N/A <br /> 5. Have rush or project due dates been checked and accepted? No N/A <br /> 6. Were all analyses within holding times at time of receipt? a No <br /> Attach labels to the containers and include a copy of the COC for i <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: 30098511 <br /> Problem: n e`TAW�IIS <br /> Resolution: a`'. <br /> Please use the back of this sheet for additional con <br /> STI�1�32�1,__ <br /> contacts) IT 0310472021!15151,,13, <br /> 00dl01n011�0{��lal�� <br />
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