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WP0042335
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042335
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Entry Properties
Last modified
3/4/2024 11:06:25 AM
Creation date
3/16/2022 9:49:53 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042335
PE
4366
STREET_NUMBER
25203
Direction
N
STREET_NAME
MAGNOLIA
STREET_TYPE
PL
City
ACAMPO
Zip
95220-
APN
00540005
ENTERED_DATE
7/23/2021 12:00:00 AM
SITE_LOCATION
25203 N MAGNOLIA PL
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\gmartinez
Tags
EHD - Public
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FGL Environmental Doc ID:3DO900002_SOP_14.DOC <br /> Revision Date: 10/10/23 Page 1 of 1 <br /> Inter-Laboratory Conditov4Jpon Receipt (Attach to COC} <br /> Sample Receipt at: CC CH ST VI <br /> 1. Number of ice chests/packages received: Shipping tracking#(s): <br /> 2. Temp IR Gun ID #: <br /> 3. Were samples received on ice? es No Temps: <br /> Surface water SWTR bact samples:A sample that has a temperature upon receipt of >100 C,whether iced or not, <br /> should be flagged unless the time since sample collection has been less than two hours. <br /> 4. Do the number of bottles received agree with the COC? e No N/A <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc.) No <br /> 6. VOAs checked for Headspace? No N/A <br /> 7. Were all analyses within holding times at time of receipt? s No <br /> 8. Verify sample date,time and sampler name No <br /> Sign and date the COC,place in a ziplock and put in t same ice chest as the samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Number of ice chests/packages received: C; Shipping tracking#(s): <br /> 07UC)61()ga.4 5 10L11 / 17K6,6 <br /> 2. Temp IR Gun ID#. <br /> 3. Were samples received on ice? es No Temps: <br /> Acceptable is above freezing to 6°C. If m packages are received at one time check for tests/H.T.'s/rushes/ <br /> 4. Do the number of bottles received agree with the COC? s 'No N/A <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc.) fes 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? No <br /> 2. Did bottle labels correspond with the client's ID's? Ites No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No FGL <br /> [Exception:Oil&Grease,VOA and CM verified in lab] <br /> 4. VOAs checked for Headspace? C�§ No N/A <br /> 5. Have rush or project due dates been checked and accepted? Yes No t A <br /> 6. Were all analyses within holding times at time of receipt? ens 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. Person Contacted: Phone Number: <br /> Initiated By: <br /> Problem: (3017919) <br /> Resolution: San Joaquin county EHO <br /> (Please use the back of this sheet for additional comments or co- STK2431852 <br /> cda 021061202417:36:31 <br /> 111 I�Il�)I111Hll�lll�lllill�1111� <br /> CTleUl I RAI> <br />
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