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WP0042566
Environmental Health - Public
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4300 - Water Well Program
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WP0042566
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Last modified
2/23/2022 12:41:39 PM
Creation date
2/23/2022 12:36:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0042566
PE
4378
STREET_NUMBER
16927
STREET_NAME
BRANDT
STREET_TYPE
WAY
City
LODI
Zip
95240-
APN
01914005
ENTERED_DATE
9/17/2021 12:00:00 AM
SITE_LOCATION
16927 BRANDT WAY
P_LOCATION
99
P_DISTRICT
004
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_SOP12-3.DOC <br />Page 1 of 1 <br />Inter -Laboratory Condition Upon Receipt (Attach to COC) ZZ- 0.2-7� <br />Sample Receipt at: K CC CH VI <br />1. Number of ice chests/packages received: _Shipping tracking # <br />2. Were samples received in a chilled condition? Temps: U. q / / / <br />Surface water SWTR bact samples: A sample that has a temperature upon receipt of > 10° C, whe <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?�$ess? <br />No <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.)No <br />5. VOAs checked for Headspace? <br />No <br />6. Were sample custody seals intact? Yes <br />No <br />7. If required, was sample split for pH analysis? Yes <br />No <br />8. Were all analyses within holding times at time of receipt?5te <br />No <br />9. Verify sample date, time and sampler name <br />No <br />Sign and date the COC, place in a ziplock and a same ice chest <br />mples. <br />Sample Receipt Review completed by (initi i <br />Sample Receipt at SP: 2 <br />1. Were samples received in a chilled condition? Temps: <br />Acceptable is above freezing to 6' i C. If many packages are received at one time check for tests/H.T.'s <br />2. Shipp*ng tracking numbers: <br />1�!� 160 <br />3. Do the number of bottles received agree with the COC? e <br />No <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) s <br />No <br />5. Were sample custody seals intact? Yes <br />No <br />Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print 1, <br />Sample Verification, Labeling and Distribution: <br />1. Were all requested analyses understood and acceptable? s No <br />2. Did bottle labels correspond with the client's ID's? No <br />3. Were all bottles requiring sample preservation properly preserved? s No <br />[Exception: Oil & Crease, VOA and CrVI 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? 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): 1,c <br />Discrepancy Documentation: <br />Any items above which are "No" or do not meet specifications (i.e. temps) must be resol <br />1. Person Contacted: Phone Number: <br />Initiated By: Date: <br />Problem: <br />Resolution: <br />2. Person Contacted: <br />Initiated By: <br />Problem: <br />Resolution: <br />(Please use the back of this sheet for additio <br />contacts) <br />(3017919) <br />Sari Joaquin Counly EHO <br />STU230274 <br />"i�000i�iiii�01' <br />iced or not, <br />N/A <br />N/A <br />NIA FGL <br />here <br />
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