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WP0042571
Environmental Health - Public
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4300 - Water Well Program
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WP0042571
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Entry Properties
Last modified
4/21/2022 3:34:15 PM
Creation date
4/21/2022 3:31:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0042571
PE
4378
STREET_NUMBER
14098
Direction
E
STREET_NAME
TOKAY COLONY
STREET_TYPE
RD
City
LODI
Zip
95240-
APN
06528006
ENTERED_DATE
9/20/2021 12:00:00 AM
SITE_LOCATION
14098 E TOKAY COLONY 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: 3D0900002_SOP_12-4.DOC <br />Page 1 of 1 <br />Inter-Lory Condition Upon Receipt (Attach to COC),�.,�,2g�3 <br />Sample Receipt at: STK CC CH VI <br />I. Number of ice chests/packages received: 1 Shipping tracking 4 <br />2. Were samples received in a chilled condition? Temps: l� / / / / <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.) S 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? VQC No /A <br />8. Were all analyses within holding times at time 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 in th ce 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'm C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br />2. Shipping tracking numbers: yam, Iq��� <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.) e 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 labe s. <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? No <br />3. Were all bottles requiring sample preservation properly preserved? No N/A FGL <br />IExccption: Oil & Crease, VOA and CM verified in lab[ <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? 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: <br />Initiated By: <br />Problem: <br />Resolution: <br />(Please use the back of this sheet for additional c <br />contacts) <br />XT.. -_T-- <br />(3017919) <br />San Joaquin County EHO <br />STU232853 <br />dao 03/0112022 08:03:56 <br />U1111l11III 1111 <br />STK223M3 <br />
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