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WP0043073
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043073
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Entry Properties
Last modified
7/20/2023 4:22:36 PM
Creation date
3/24/2023 10:46:55 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043073
PE
4378
STREET_NUMBER
31296
Direction
E
STREET_NAME
ROSSIER
STREET_TYPE
RD
City
ESCALON
Zip
95320-
APN
22920008
ENTERED_DATE
3/14/2022 12:00:00 AM
SITE_LOCATION
31296 E ROSSIER 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- to Condition Upon Receipt (Attach to COC <br /> i`Y P P ) <br /> Sample Receipt at: STK CC CH VI <br /> 1. Number of ice ages 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. es No <br /> 5. VOAs checked for Headspace? Yes N <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? a No <br /> 9. Verify sample date,time and sampler name No <br /> Sign and date the COC,place in a ziplock and put in Ae same ice chest as t e samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: <br /> 1. Were samples received in a chilled condition? Temps: 64? I La _c/ <br /> Acceptable is above freezing to 60 C. If many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 2. Shi ping tracking numbers: <br /> � ! qW`)CA( L,7 2�- <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.) Qs No <br /> 5. Were sample custody seals intact? Yes No N/ <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? es 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 /> lException:Oil&Grease,VOA and CrVI verified in lab) <br /> 4. VOAs checked for Headspace? Yes No / <br /> 5. Have rush or project due dates been checked and accepted? Yes No <br /> 6. Were all analyses within holding times at time of receipt? No <br /> Attach labels to the containers and include a copy of the COC for lab de iv <br /> o. <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: Phone Number: <br /> Initiated By: Date: <br /> Problem: <br /> Resolution: <br /> (Please use the back of this sheet for additional comments or Attach label with lab number here <br /> contacts) <br />
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