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WP0039584
Environmental Health - Public
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4300 - Water Well Program
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WP0039584
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Entry Properties
Last modified
3/10/2022 4:45:38 PM
Creation date
3/10/2022 4:44:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0039584
PE
4378
STREET_NUMBER
17602
Direction
S
STREET_NAME
LAWRENCE
STREET_TYPE
RD
City
ESCALON
Zip
95320-
APN
22903026
ENTERED_DATE
5/6/2019 12:00:00 AM
SITE_LOCATION
17602 S LAWRENCE RD
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_SOP_12-3.DOC <br />Page 1 of 1 <br />Inter -L tory Condition Upon Receipt (Attach to COQ,�WJ4o,?3 <br />Sample Receipt at: (!T-,�J- <br />1. <br />CC CH VI <br />Number of ice chespakages received: _Shipping tracking # <br />2. Were samples received in a chilled condition? Temps:• <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.)les <br />es 3 No <br />5. VOAs checked for Headspace? No <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? Y (F0 C� <br />9. Verify sample date, time and sampler name Ite; <br />No `�rSign and date the COC, place in a ziplock and put in a 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: I / / / / _ <br />Acceptable is above freezing to 6-w C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br />2. Shipping tracking numbers: <br /><T;Syl 0I Ce 50 / 9ND <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 <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? <br />No <br />2. Did bottle labels correspond with the client's ID's? <br />No <br />3. Were all bottles requiring sample preservation properly preserved?es <br />No N/A FGL <br />[Exception: Oil & Grease, VOA and CM 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 / <br />6. Were all analyses within holding times at time of receipt? (e <br />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): <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 additional cc <br />contacts) <br />„o„s,s, <br />San Joaquin Caunfy ENO <br />STK2230683 <br />
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