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WP0043226
Environmental Health - Public
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4300 - Water Well Program
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WP0043226
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Entry Properties
Last modified
9/14/2022 9:43:05 AM
Creation date
8/1/2022 1:34:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4300 - Water Well Program
RECORD_ID
WP0043226
PE
4378
STREET_NUMBER
11801
Direction
W
STREET_NAME
MOUNTAIN VIEW
STREET_TYPE
RD
City
TRACY
Zip
95376-
APN
24203045
ENTERED_DATE
4/27/2022 12:00:00 AM
SITE_LOCATION
11801 W MOUNTAIN VIEW RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\tsok
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EHD - Public
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FGL Environmental Doc ID:3DO900002_SOP_12.DOC <br /> Revision Date: 10/09/14 Page 1 of 1 <br /> Inter-L tory Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at: (STi'D CC CH VI <br /> 1. Number of ice chests/packages received: / Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps-A0 <br /> Surface water SWTR bact samples: A sample that has a temperature upon receipt of >14°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.) Yes No <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 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 t same ice chest as the samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: <br /> Acceptable is above freezing to 6`w C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: ' <br /> 3. Do the number of bottles received agree with the COC? e No N/A <br /> 4. Were samples received intact?(i.e. no broken bottles, leaks etc.) s No <br /> 5. Were sample custody seals intact? es No <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? No N/A FGL <br /> [Exception:Oil&Grease,VOA and CM verified in lab/ <br /> 4. VOAs checked for Headspace? Yes No NIA <br /> 5. Have rush or project due dates been checked and accepted? Yes No UK <br /> 6. Were all analyses within holding times at time of receipt? e No <br /> Attach labels to the containers and include a copy of the COC for ltbr. <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 /> I. Person Contacted: Phone Number: <br /> Initiated By: Date: <br /> Problem: <br /> Resolution: <br /> 2. Person Contacted: Phone Number: - <br /> Initiated By: (3017919) <br /> Problem: San Joaquin CountyEHO <br /> Resolution. <br /> (Please use the back of this sheet for additional cc STU250422 <br /> contacts) cda 071251202216:48:05 <br /> U1111111111111111 <br /> STK2250422 <br />
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