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WP0042569
Environmental Health - Public
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4300 - Water Well Program
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WP0042569
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Entry Properties
Last modified
4/6/2022 9:09:03 AM
Creation date
4/6/2022 8:31:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0042569
PE
4378
STREET_NUMBER
8858
Direction
E
STREET_NAME
FAIRCHILD
STREET_TYPE
LN
City
STOCKTON
Zip
95215-
APN
08908003
ENTERED_DATE
9/20/2021 12:00:00 AM
SITE_LOCATION
8858 E FAIRCHILD LN
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_12-4.DOC <br />Page 1 of 1 <br />Inter-Lpbofa,tory Condition Upon Receipt (Attach to COC) ���'� 7 <br />Sample Receipt at: ST CC CH VI I <br />1. Number of ice ch ckages received: Shipping tracking # <br />G <br />2. Were samples received in a chilled condition? Temps:/0 ' / <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.) �eNo <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? Yes No <br />8. Were all analyses within holding times at ti of receipt? No <br />9. Verify sample date, time and sampler name Yes No <br />Sign and date the COC, place in a ziplock and put i e e 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 tin - check for tests ? s rushes/ <br />2. Shipping tracking numbers: f�-, --s3 <br />3. Do the number of bottles received agree with the COC? n No N/A <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) e No -� <br />5. Were sample custody seals intact? Yes No - A) <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? e No <br />2. Did bottle labels correspond with the client's ID's? No <br />3. Were all bottles requiring sample preservation properly preserved? es No N/A FGL <br />[Exception: Oil & Grease, 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? JLe9 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): -C -1 -A -- <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 />(3017919) u <br />2. Person Contacted: <br />_ San Joaquin Counfy EHD <br />Initiated By: <br />STK2232777Problem: <br />Resolution: iv 02/2512022 15:23:49 <br />(Please use the back of this sheet for additions_ <br />111 1111 ere <br />contacts) <br />
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