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CO0054779 (2)
Environmental Health - Public
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2200 - Hazardous Waste Program
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CO0054779 (2)
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Entry Properties
Last modified
11/19/2024 10:19:26 AM
Creation date
6/29/2022 3:16:34 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
RECORD_ID
CO0054779
PE
2200
STREET_NUMBER
3566
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95304
APN
23906018
ENTERED_DATE
3/28/2022 12:00:00 AM
SITE_LOCATION
3566 W ELEVENTH ST
RECEIVED_DATE
3/28/2022 12:00:00 AM
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\ymoreno
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EHD - Public
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f--0M McCampbell Analytical, Inc. <br />"When Quality Counts" <br />1534 Willow Pass Road, Pittsburg, CA 94565-1701 <br />Toll Free Telephone: (877) 252-9262 / Fax: (925) 252-9269 <br />http://www.mccampbell.com / E-mail: main nccampbell.com <br /> <br />Sample Receipt Checklist <br />Chain of custody signed when relinquished and received? <br />Client Name: Atlas Technical Consultants <br />Project: 91-57962-PW; FUHSD <br />WorkOrder Ns: 2102A42 Matrix: Soil <br />Carrier: Lorenzo Perez (MAI Courier) <br />Chain of custody present? <br />Chain of custody agrees with sample labels? <br />Sample IDs noted by Client on COC? <br />Date and Time of collection noted by Client on COC? <br />Sampler's name noted on COC? <br />COC agrees with Quote? <br />Custody seals intact on shipping container/cooler? <br />Shipping container/cooler in good condition? <br />Samples in proper containers/bottles? <br />Sample containers intact? <br />Sufficient sample volume for indicated test? <br />Date and Time Received <br />Date Logged: <br />Received by: <br />Logged by: <br />Chain of Custody (COC) Information <br />Yes II No E <br />Yes No El <br />Yes No E <br />Yes No El <br />Yes El No EL <br />Yes No El <br />Yes EL No El <br />Sample Receipt Information <br />Yes EL <br />No El <br />Yes No El <br />Yes No El <br />Yes No El <br />Yes No EL <br />2/17/2021 14:45 <br />2/18/2021 <br />Tina Perez <br />Tina Perez <br />NA LI <br />NA El <br />Sample Preservation and Hold Time (HT) Information <br />All samples received within holding time? Yes EI No El <br /> <br />NA Eli <br />Samples Received on Ice? Yes IJ No E <br />(Ice Type: WET ICE <br />Sample/Temp Blank temperature <br /> Temp: 2.2°C <br /> NA EI <br />ZHS conditional analyses: VOA meets zero headspace <br /> Yes E No El <br />NA <br />requirement (VOCs, TPHg/BTEX, RSK)? <br />Sample labels checked for correct preservation? <br />pH acceptable upon receipt (Metal: <2; Nitrate 353.2/4500NO3: <br /><2; 522: <4; 218.7: >8)? <br />UCMR Samples: <br />pH tested and acceptable upon receipt (200.8: 5.2; 525.3: 54; <br />530: 57; 541: <3; 544: <6.5 & 7.5)? <br />Free Chlorine tested and acceptable upon receipt (<0.1mg/L)? <br />Yes <br />NoEL <br />Yes Ei <br /> <br />No El <br />NA El <br />Yes E <br />No Eli <br />NA El <br />Yes El <br />No E <br />NA El <br />Comments <br />Page 68 of 68
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