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WP0040933
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0040933
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Last modified
11/22/2021 2:53:48 PM
Creation date
11/3/2021 1:23:57 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0040933
PE
4370
STREET_NUMBER
1282
STREET_NAME
CORWIN
STREET_TYPE
DR
City
MANTECA
Zip
95337-
APN
22231005
ENTERED_DATE
6/30/2020 12:00:00 AM
SITE_LOCATION
1282 CORWIN DR
P_LOCATION
04
P_DISTRICT
005
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 /> Inter-L tory Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at: STK CC CH VI <br /> 1. Number of ice chests/packages received: C Shipping tracking # <br /> 2. Were samples received in a chilled condition? Temps: %D,("/ / / / <br /> Surface water SWTR bact samples: A sample that has a temperature upon receipt of >I 0'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.) rYtes )No <br /> 5. VOAs checked for Headspace? Yes No <br /> 6. Were sample custody seals intact? Yes No <br /> 7. If required, was sample split for pH analysis? Ye No N/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 pue ice chest as t e samples. <br /> Sample Receipt Review completed by (initials): / <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: ) / <br /> Acceptable is above freezing to 6E C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: <br /> C,5L15vlrj k <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. Were sample custody seals intact? Yes No I/ , <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? No <br /> 3. Were all bottles requiring sample preservation properly preserved? 9 No N/A FGL <br /> (Exception:Oil&Grease,VOA and CM verified in labl <br /> 4. VOAs checked for Headspace? Yes No / <br /> 5. Have rush or project due dates been checked and accepted? Yes No / <br /> 6. Were all analyses within holding times at time of receipt? Iell No <br /> Attach labels to the containers and include a copy of the COC for lab <br /> delivery. <br /> Sample Receipt, Login and Verification completed by (initials): /�;f <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: Phone Number: <br /> Initiated By: <br /> Problem: San <br /> (3017919) <br /> Resolution: Joaquin County EHD <br /> (Please use the back of this sheet for additional corn STK2152566 <br /> contacts) iv 091021202115:42:37 <br /> pl III II III IIIIIIIilllllllllllllll III III <br />
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