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WP0042149
Environmental Health - Public
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4300 - Water Well Program
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WP0042149
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Entry Properties
Last modified
4/6/2022 8:50:30 AM
Creation date
4/6/2022 8:30:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0042149
PE
4378
STREET_NUMBER
17975
Direction
S
STREET_NAME
AUSTIN
STREET_TYPE
RD
City
MANTECA
Zip
95336-
APN
20833015
ENTERED_DATE
6/14/2021 12:00:00 AM
SITE_LOCATION
17975 S AUSTIN RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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FGL Environmental Doc ID: 3DO900002_SOP_12-4.DOC <br />Revision Date: 10/09/14 Page 1 of 1 <br />Inter-rSTK <br />tory Condition Upon Receipt (Attach to COC) <br />Sample Receipt at: CC CH VI <br />1. Number of ice ckages received: _Shipping tracking # <br />2. Were samples received in a chilled condition? Temps: //1 / / / / <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 />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.) Ye No <br />5. VOAs checked for Headspace? Yes No <br />6. Were sample custody seals intact? Yes No <br />7. If required, was sample split for pH analysis? No /A <br />8. Were all analyses within holding times at time of receipt? No <br />9. Verify sample date, time and sampler nam es No <br />Sign and date the COC, place in a ziplock andput int ame ice chest as the samples. <br />Sample Receipt Review completed by (initials): <br />Sample Receipt at SP: <br />1. Were samples received in a chilled condition? Temps: <br />Acceptable is above freezing to 6`® C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br />2. Shipping tracking numbers: <br />3. Do the number of bottles received agree with the COC? es No N/A <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) es No <br />5. Were sample custody seals intact? Yes No N/ <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? s No <br />2. Did bottle labels correspond with the client's ID's? es` 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 dTA <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? 6 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):_v <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: T� (3017919) <br />Initiated By: <br />Problem: San Joaquin County EN <br />Resolution: STP232501 <br />(Please use the back of this sheet for additional iv 0211812022 07:45:01 <br />contacts) IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII <br />re <br />
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