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WP0041564
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0041564
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Entry Properties
Last modified
4/17/2023 11:11:11 AM
Creation date
4/3/2023 2:55:51 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0041564
PE
4370
STREET_NUMBER
30331
Direction
E
STREET_NAME
LONE TREE
STREET_TYPE
RD
City
OAKDALE
Zip
95361-
APN
20729072
ENTERED_DATE
12/29/2020 12:00:00 AM
SITE_LOCATION
30331 E LONE TREE 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-L0"-,tory <br /> �tor3Condition Uponon Receipt (At <br /> tach to COC)o?33,E&� <br /> Sample Receipt at: STK CC CH VI `{ <br /> 1. Number of ice chests/packages received: Shipping tracking# <br /> 2. Were samples received in a chilled condition? Temps: r/*00Z <br /> Surface water SWTR bact samples:A sample that has a temperature upon receipt of >I 01 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? Yes No <br /> 6. Were sample custody seals intact? Yes No <br /> 7. If required, was sample split for pH analysis? Yes No A <br /> 8. Were all analyses within holding times at time of receipt? a No <br /> 9. Verify sample date,time and sampler name es No <br /> Sign and date the COC,place in a ziplock and put in th a 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: 4—/-/ <br /> A <br /> Acceptable is above freezing to 6U C. If many packages are received at one time check/for tests/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: ✓ �"I��'l��j�i� l J�IJ ��� <br /> C1f1?j;r-1 Gl � <br /> 3. Do the number of bottles received agree with the COC? s No N/A <br /> 4. Were samples received intact?(i.e. no broken bottles, leaks etc.) a No <br /> 5. Were sample custody seals intact? Yes No /A <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? &0 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 FGL <br /> lException:Oil&Grease,VOA and CM 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? iis 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): <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: (3017919) <br /> Initiated By: San Joaquin County END <br /> Problem. <br /> Resolution: STU333064 <br /> (Please use the back of this sheet for additional cc iv 03109/2023 08:00:50 <br /> contacts) 011�ll�llllll�l1!!1l111111l �I�1 <br /> STK2333064 <br />
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