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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 Con ' ' Upon Receipt (Attach to COC) �$ l <br /> Sample Receipt at: CC CH ST VI <br /> 1. Number of ice chests/packages receive : Shipping tracking#(s): <br /> 2. Temp IR Gun ID# <br /> 3. Were samples received on ice? OYesNo TempsSurface water SWTR bact samples:A hat 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 /> 4. Do the number of bottles received agree with the COC? No N/A <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc.) No <br /> 6. VOAs checked for Headspace? Yes No N/ <br /> 7. Were all analyses within holding times at time of receipt? No <br /> 8. Verify sample date,time and sampler name q9 No <br /> Sign and date the COC,place in a ziplock and put in th same ice chest as the samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Number of ice chests/ ackages received: Shipping tracking#(s): <br /> c,&16(0S,*g5 5-�--3' -7 &S <br /> 2. Temp IR Gun ID #: <br /> 3. Were samples received on ice? e No Temps: -Q- <br /> Acceptable <br /> 2Acceptable is above freezing to 6°C. If many 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? e No N/A <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc.) es 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? Ves, No <br /> 2. Did bottle labels correspond with the client's ID's? Les No <br /> 3. Were all bottles requiring sample preservation properly preserved? es No N/A FGL <br /> [Exception:Oil&Grease,VOA and CM verified in lab] <br /> 4. VOAs checked for Headspace? Yes No I CA <br /> 5. Have rush or project due dates been checked and accepted? Yes No NrA <br /> 6. Were all analyses within holding times at time of receipt? Y%Z)`s 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 <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: Dates — - <br /> Problem: (3017919) <br /> Resolution: San Joaquin County EHD <br /> (Please use the back of this sheet for additional comments or co STU431851 <br /> cda 021061202417:36:38 <br /> 1111l111�1�1Uia�111�llllll�l!![� <br /> STK?4Z1A41 <br />
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