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SR0084419_SSNL
Environmental Health - Public
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2600 - Land Use Program
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SR0084419_SSNL
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Entry Properties
Last modified
4/27/2022 9:14:08 AM
Creation date
4/27/2022 8:57:01 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0084419
PE
2602
FACILITY_NAME
MAIRA NAVARRO
STREET_NUMBER
336
Direction
E
STREET_NAME
WATTERS
STREET_TYPE
RD
City
FRENCH CAMP
Zip
95231
APN
19331004
ENTERED_DATE
10/29/2021 12:00:00 AM
SITE_LOCATION
336 E WATTERS RD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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FGL Environm <br />Revision Date: 1 <br />1 <br />Sample Receip <br />at: ST <br />1. Number o ice chests/packages received: Shipping tracking <br />2. Were sam 1 <br />Surface wat <br />should be flagged Mess the time since sample collection has been less than two hours. <br />3. Do thenumber of bottles received agree with the COC? No N/A <br />4. Were sam les received intact? (i.e. no broken bottles, leaks etc.) No <br />5. VOAs checked for Headspace? Yes No NLA <br />6. Were sam le custody seals intact? Yes No <br />7. If require , was sample split for pH analysis? Y No / <br />8. Were all analyses within holding times at time of receipt? No <br />9. Verify s ple date, time and sampler name Yes No <br />Sign and date t e COC, place in a ziplock and put in the ice chest as t e samples. <br />Sample Receipt Review completed by (initials): <br />Sample Receiptat SP: <br />1. Were samples received in a chilled condition? Temps: <br />Acceptable i above freezing to 6E C. If many packages are received at one time check for tests/H.T.'s/rushes/ � f,�y.�l <br />2. Shipping tacking numbers: t � I g <br />I I 4�C, I&� <br />3. Do thenumber of bottles received agree with the COC? No N/A <br />4. Were sam les received intact? (i.e. no broken bottles, leaks etc.) e No <br />5. Were sample custody seals intact? Yes No 1/ <br />Sign and date th COC, obtain LIMS sample numbers, select methods/tests and print labels. <br />Sample Verific tion, 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? e No <br />3. Were all bottles requiring sample preservation properly preserved? Yes No FGL <br />(Exception: Oil & Grease. VOA and CM verified in labl <br />4. VOAs checked for Headspace? Yes NoJA <br />5. Have rush r project due dates been checked and accepted? Yes No <br />6. Were all a alyses within holding times at time of receipt? No <br />Attach labels to he containers and include a copy of the COC for I delive . <br />Sample Receipt, Login and Verification completed by (initials): <br />Discrepancy Documentation: <br />Any items abovewhich are "No" or do not meet specifications (i.e. temps) must be resolved. <br />1. Person Co tacted: Phone Number: <br />Initiated BY: Date: <br />Problem: <br />Resolution I (3016608) <br />2. Person Co tacted: Live Oak 080 Enurronmenfal <br />Initiated B <br />Problem: STIU154072 <br />Resolution Iv 09/30/2021 <br />9 30//(202f1g16.13:27 <br />(Please use the back of this sheet for additional comments or <br />contacts) <br />4 <br />Doc ID: 3D0900002_SOP_12-3.DOC <br />Page 1 of 1 <br />Iter -L tory Condition Upon Receipt (Attach to COC) or1ff 07� <br />CC CH Vl <br />� # <br />es received in a chilled condition? Temps: -/, / <br />r SWTR bact samples: A sample that has a temperature upon receipt of >10° C, whether iced or not, <br />
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