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WP0041197
Environmental Health - Public
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4300 - Water Well Program
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WP0041197
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Last modified
5/5/2022 8:43:28 AM
Creation date
5/5/2022 8:36:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0041197
PE
4366
STREET_NUMBER
24467
Direction
N
STREET_NAME
JAHANT
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
00740032
ENTERED_DATE
9/4/2020 12:00:00 AM
SITE_LOCATION
24467 N JAHANT 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.DOC <br />Page 1 of 1 <br />Inter;kO tory Condition Upon Receipt (Attach to COC) 0,111AOX <br />Sample Receipt a . TK CC CH VI <br />1. Number of ' e c packages received: _Shipping tracking # <br />2. Were samples received in a chilled condition? Temps: J1J1 / <br />Surface water SWTR bact samples: A sample that has a temperature upon receipt of >I0' 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 etNo <br />5. VOAs checked for Headspace? es No <br />6. Were sample custody seals intact? Yes No <br />7. If required, was sample split for pH analysis? No <br />8. Were all analyses within holding times at time of receipt? No <br />9. Verify sample date, time and sampler name No <br />Sign and date the COC, place in a ziplock and put in e e ice ch a samples. <br />Sample Receipt Review completed by (initials): <br />Sample Receipt at SP: <br />1. Were samples received in a chilled condition? Temps: 2- C- <br />Acceptable is above freezing to 6B C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br />2. Shipping tracking numbers: 'SS �t l Uq Sq S <br />3. Do the number of bottles received agree with the COC?e <br />No N/A <br />4. Were samples received intact? (i.e. no broken bottles, leaks etc.) es <br />No <br />5. Were sample custody seals intact? Yes <br />No/ <br />Sign and date the COC, obtain LIMS sample numbers, select methods/tests and print Labe . <br />Sample Verification, Labeling and Distribution: <br />1. Were all requested analyses understood and acceptable? e <br />No <br />2. Did bottle labels correspond with the client's ID's? es <br />No <br />3. Were all bottles requiring sample preservation properly preserved? es <br />No N/A FGL <br />[Exception: Oil & Grease, VOA and CM verified in lab! <br />f4 <br />4. VOAs checked for Headspace? Yes <br />No /A <br />5. Have rush or project due dates been checked and accepted? Yes <br />No /A <br />6. Were all analyses within holding times at time of receipt? es <br />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):MSC, <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 comp <br />contacts) <br />Phone Number: <br />(3017919) <br />San Joaquin County EHO <br />STK2234268 <br />iv 0313112022 06:48:50 <br />Il Il � Slalll�l 116 I Ill i <br />
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