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WP0042765
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0042765
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Entry Properties
Last modified
8/30/2023 4:33:09 PM
Creation date
6/10/2022 1:42:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0042765
PE
4366
STREET_NUMBER
30051
Direction
E
STREET_NAME
GROOMS
STREET_TYPE
RD
City
OAKDALE
Zip
95361-
APN
20729060
ENTERED_DATE
11/29/2021 12:00:00 AM
SITE_LOCATION
30051 E GROOMS RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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FGL Environmental Doc ID:3D0900002_SOP_12.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter- ory Condition Upon Receipt (Attach to COC)�W/37 <br /> Sample Receipt at: STK CC CH VI <br /> 1. Number of ice c packages received: Shipping tracking# _ <br /> 2. Were samples received in a chilled condition? Temps- ':� / <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.) Y No <br /> 5. VOAs checked for Headspace? No N/A <br /> 6. Were sample custody seals intact? Yes No N/ <br /> 7. If required, was sample split for pH analysis? Yes No / <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date,time and sampler name 5 No <br /> Sign and date the COC,place in a ziplock and put in same ice chest as the samples. <br /> Sample Receipt Review completed by (initials): <br /> 11 <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 time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: <br /> I c sd--, a_t34;�, <br /> 3. Do the number of bottles received agree with the COC? Yas No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> 5. Were sample custody seals intact? Yes Nom' <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? No <br /> 3. Were all bottles requiring sample preservation properly preserved? Yes No (a/ <br /> A FGL <br /> [Exception:Oil&Grease,VOA and CM verified in labl <br /> 4. VOAs checked for Headspace? es No N/A <br /> 5. Have rush or project due dates been checked and accepted? Yes No EA <br /> 6. Were all analyses within holding times at time of receipt? a No <br /> Attach labels to the containers and include a copy of the COC fo deliv <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: (3017919) <br /> Problem: San Joaquin County EHDResolution. <br /> (Please use the back of this sheet for additional co ST12335137 <br /> contacts) <br /> iv 04/26/2023 07:57:32 <br /> � <br /> 11!Ill ll�1lllflllllllllllll�ll11111111 <br /> STK233S137 <br />
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