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CO0054134_WELL WATER TEST RESULTS & LETTER
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CO0054134_WELL WATER TEST RESULTS & LETTER
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Last modified
10/31/2022 11:35:13 AM
Creation date
10/27/2021 1:29:25 PM
Metadata
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Template:
EHD - Public
ProgramCode
4300 - Water Well Program
FileName_PostFix
WELL WATER TEST RESULTS & LETTER
RECORD_ID
CO0054134
PE
4200
STREET_NUMBER
593
STREET_NAME
FISHBACK
STREET_TYPE
WAY
City
MANTECA
Zip
95337
APN
22210017
ENTERED_DATE
8/11/2021 12:00:00 AM
SITE_LOCATION
593 FISHBACK WY
RECEIVED_DATE
8/11/2021 12:00:00 AM
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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FGL Environmental <br />Revision Date: 10/09/14 <br />Doc ID: 3DO900002_SOP_12-3.DOC <br />Page 1 of 1 <br />Inter-L#bQqatory Condition Upon Receipt (Attach to COC) <br />Sample Receipt at:STK ' CC CH VI <br />1. Number of ice the ts�/packages received: Shipping tracking # <br />2.. Were samples received in a chilled condition? Temps: b- � / / / / <br />Surface water SWTR bact samples: A sample that has a temperature upon receipt of >101 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.)Yes ' No <br />5. VOAs checked for Headspace? Yes No A <br />6. Were sample custody seals intact? Yes No <br />7. If required, was sample split for pH analysis? Y es No NJ/A` <br />8. Were all analyses within holding times at time of receipt? No <br />9. Verify sample date, time and sampler name Yes No <br />Sign and date the COC, place in a ziplock and put in thg s e ice chest as samples. <br />Sample Receipt Review completed by (initials): , <br />Sample Receipt at SP: <br />1. Were samples received in a chilled condition? Temps: / A <br />Acceptable is above freezing to 6 ❑ C. If many pack es are received at one time check for tests/H.T.'s/rashes/ <br />2. Shipping trackin bers: <br />3. Do the umber of bottles received a ree with the COC? No N/A <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.)Yes 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 <br />No <br />2. Did bottle labels correspond with the client's ID's? es <br />No <br />3. Were all bottles requiring sample preservation properly preserved? Yes <br />No N/A FGL <br />[Exception: Oil & Grease, VOA and CrVI verified in lab] <br />4. VOAs checked for Headspace? Yes <br />No / <br />5. Have rush or project due dates been checked and accepted? Yes <br />No N/A <br />6. Were all analyses within holding times at time of receipt?Y� <br />No <br />Attach labels to the containers and include a copy of the COC 1' <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. <br />Person Contacted: <br />Initiated By: <br />Problem: <br />Resolution: <br />(Please use the back of this sheet for additio <br />contacts) <br />here <br />
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