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WP0042732
Environmental Health - Public
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4300 - Water Well Program
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WP0042732
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Entry Properties
Last modified
4/6/2022 9:12:37 AM
Creation date
4/6/2022 8:37:13 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0042732
PE
4378
STREET_NUMBER
2475
Direction
W
STREET_NAME
SARGENT
STREET_TYPE
RD
City
LODI
Zip
95242-
APN
02516053
ENTERED_DATE
11/8/2021 12:00:00 AM
SITE_LOCATION
2475 W SARGENT 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_12-4.DOC <br />Page 1 of 1 <br />Inter -L tory Condition Upon Receipt (Attach to COC) Vg:g J1' <br />Sample Receipt at: ST CC CH VI <br />1. Number of ice chess packages received: % Shipping tracking # <br />2. Were samples received in a chilled condition? Temps: V, 9 / / / / <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? <br />No N/A <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) <br />Ye No <br />5. VOAs checked for Headspace? <br />Yes No <br />6. Were sample custody seals intact? <br />Yes No <br />7. If required, was sample split for pH analysis? <br />Y No <br />8. Were all analyses within holding times at time of receipt? <br />No <br />9. Verify sample date, time and sampler name <br />a No <br />Sign and date the COC, place in a ziplock and p t in e s e ice chest as a samples. <br />Sample Receipt Review completed by (initials): <br />Sample Receipt at SP: <br />1. Were samples received in a chilled condition? Temps: �3>/ <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: �/�(�/q!4497S-33, qX02wrol <br />/�/v`U)t I, <br />3. Do the number of bottles received agree with the COC? No <br />N/A <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) a No <br />CEO <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? No <br />2. Did bottle labels correspond with the client's ID's? s No <br />3. Were' all bottles requiring sample preservation properly preserved? <1esNo <br />N/A FGL <br />(Exception: Oil & Grease, VOA and CM verified in labl <br />4. VOAs checked for Headspace? Yes No <br />5. Have rush or project due dates been checked and accepted? Ye No <br />6. Were all analyses within holding times at time of receipt? ' 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 />(3017919) <br />2. Person Contacted: San Joaquin Counfy <br />Initiated By: En <br />Problem: STK2233303 <br />Resolution: <br />03/09/2022 07:23:18 <br />here <br />IIIiv <br />(Please use the back of this sheet for additio 11111[1111111ltll� ! <br />1 <br />contacts) STX22333M <br />
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