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COACHIWUV (2)
Environmental Health - Public
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2200 - Hazardous Waste Program
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COACHIWUV (2)
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Last modified
2/8/2022 1:13:56 PM
Creation date
2/8/2022 1:07:11 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
RECORD_ID
COACHIWUV
PE
2200
STREET_NUMBER
1627
STREET_NAME
INDUSTRIAL
STREET_TYPE
DR
City
STOCKTON
Zip
95206
APN
17732008
ENTERED_DATE
10/14/2021 12:00:00 AM
SITE_LOCATION
1627 INDUSTRIAL DR SUITE B
RECEIVED_DATE
10/14/2021 12:00:00 AM
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\ymoreno
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EHD - Public
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Section 1 <br />Client' EnvIro-Chem <br />Date Received • 09/29/2020 <br />Project: 200928-12 <br />Sampler's Name Present: Dies No <br />Semple Temp (*C) <br />(No Cooler) 1:1 No (skip section 2) <br />Section 2 <br />Sample(s) received In a cooler? 111Yes, How many? 1 <br />Sample Temp (°C), One from each cooler: #1: 2.5 #2: #3: <br />(Acceptance range Is < 6T but not frozen (for Microbiology samples, acceptance range Is <10T but net frozen). Iris acceptable for samples collected <br />the some day or sample receipt to have a higher temperature as long CO there is evidence that cooling has begun.) <br />Shipping Information: <br />#4: <br />ENTHALPY % ANALYTICAL <br />SAMPLE ACCEPTANCE CHECKLIST <br />Section 3 <br />Was the cooler packed with: <br />Cooler Temp (aC): #1: 01 <br />Ice <br />Paper <br />Packs Bubble Wrap LjStyrofoam <br />El Other None <br />i Ice <br />#2: #3: #4: <br />Section 4 YES NO N/A <br />Was a COC received? i <br />Are sample IDs present? It <br />Are sampling dates & times present? i <br />Is a relinquished signature present? I <br />Are the tests required clearly indicated on the COC? i <br />Are custody seals present? i <br />If custody seals are present, were they intact? i <br />Are all samples sealed In plastic bags? (Recommended for Microbiology samples) it <br />Did all samples arrive intact? If no, indicate In Section 4 below. I/ <br />Did all bottle labels agree with COC? (ID, dates and times) yr <br />Were the samples collected In the correct containers for the required tests? i <br />Are the containers labeled with the correct preservatives? i <br />Is there headspace in the VOA vials greater than 5-6 mm In diameter? i <br />Was a sufficient amount of sample submitted for the requested tests? i <br />Section 5 Explanations/Comments <br />Section 6 <br />For discrepancies, how was the Project Manager notified? EVerbal PM initials: Date/Time <br />DEmail (email sent to/on): <br />Project Manager's response: <br />07A. ,726,/ Completed Date: <br />Enthalpy Analytical, a subsidiary of Montrose Environmental Group ,Inc. <br />931W. Barkley Ave, Orange, CA 921368 • T: (714) 771-6900 • F: (714) 538-1209 <br />www.enthaipy.com/socal <br />Sample Acceptance Checklist — Rev 4, 8/8/2017 <br />5of9
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