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COH34DNBK
Environmental Health - Public
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MAYBECK
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2500 – Emergency Response Program
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COH34DNBK
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Last modified
5/2/2023 1:20:18 PM
Creation date
5/2/2023 1:16:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COH34DNBK
PE
2546
STREET_NUMBER
6660
STREET_NAME
MAYBECK
STREET_TYPE
RD
City
STOCKTON
Zip
95206
APN
16206001
ENTERED_DATE
6/17/2022 12:00:00 AM
SITE_LOCATION
6660 MAYBECK RD, STOCKTON
RECEIVED_DATE
6/17/2022 12:00:00 AM
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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SJGOV\bmascaro
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EHD - Public
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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@mccampbell.com <br /> <br />Sample Receipt Checklist <br />Client Name: US Ecology <br />Project: 180641; Alpine Helicopter <br />WorkOrder N2: 2207760 Matrix: Soil <br />Carrier: Client Drop-In <br />Date and Time Received: <br />Date Logged: <br />Received by: <br />Logged by: <br />7/13/2022 14:30 <br />7/14/2022 <br />Lilly Ortiz <br />Agustina Venegas <br />Chain of Custody (COCI Information <br />No 0 <br />No <br />No <br />No 0 <br />No 0 <br />No 0 <br />No 0 <br />Chain of custody present? <br />Chain of custody signed when relinquished and received? <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 />Custody seals intact on sample bottles? <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 />Yes <br />Yes <br />Yes <br />Yes <br />Yes <br />Yes <br />Yes <br />Yes <br />Yes <br />Yes <br />Yes <br />Yes LI <br />Yes <br />No <br />No E <br />No E <br />No E <br />No 0 <br />No 0 <br />NA 0 <br />NA El <br />NA 0 <br />Sample Receipt Information <br />Sample Preservation and Hold Time (HT) Information <br />NA LII <br />NA CI <br />NA <br />All samples received within holding time? Yes No 0 <br />Samples Received on Ice? Yes No E <br />(Ice Type: WET ICE <br />Sample/Temp Blank temperature Temp: 3.8°C <br />ZHS conditional analyses: VOA meets zero headspace Yes No 0 <br />requirement (VOCs, TPHg/BTEX, RSK)? <br />Sample labels checked for correct preservation? Yes El No El <br />pH acceptable upon receipt (Metal: <2; Nitrate 353.2/4500NO3: Yes 0 No 0 NA 0 <br /><2; 522: <4; 218.7: >8)? <br />IJCMR Samples: <br />pH tested and acceptable upon receipt (200.7: 52; 533: 6 -8; Yes 0 No 0 NA <br />537.1: 6 - 8)? <br />Free Chlorine tested and acceptable upon receipt (<0.1mg/L) Yes 0 No 0 NA 0 <br />[not applicable to 200.71? <br />Comments: <br />Page 29 of 29
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