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WP0044385
Environmental Health - Public
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VAN ALLEN
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4200/4300 - Liquid Waste/Water Well Permits
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WP0044385
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Entry Properties
Last modified
8/31/2023 2:34:18 PM
Creation date
7/20/2023 4:08:19 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0044385
PE
4380
STREET_NUMBER
20481
Direction
S
STREET_NAME
VAN ALLEN
STREET_TYPE
RD
City
ESCALON
Zip
95320-
APN
24512012
ENTERED_DATE
3/31/2023 12:00:00 AM
SITE_LOCATION
20481 S VAN ALLEN RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\gmartinez
Tags
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- tory Condition Upon Receipt (Attach to COC) <br /> Sample Receipt at: STKCC CH VI <br /> 1. Number of ice ches s packages 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.) Yes No <br /> 5. VQAs checked for Headspace? Yes No <br /> 6. Were sample custody seals intact? Yes No /A <br /> 7. If required,was sample split for pH analysis? Y No N/A <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. V�rify sample date, time and sampler name Yes No <br /> Sign and date the COC,place in a ziplock and put in,thee 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❑ C. If�m y cka es are rec ived at one ti a check for test T.'s/rushes/ <br /> 2. Slipping tracking numbers: <br /> 3. Do the number of bottles received agree with the COC? es No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> 5. Were sample custody seals intact? Yes No <br /> Sign and date the COC,obtain LIMS sample numbers, select methods/tests and print labe n. <br /> Sample`Verification,Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? Ye No <br /> 2. Did bottle labels correspond with the client's ID's? es No <br /> 3. Were all bottles requiring sample preservation properly preserved? e No N/A FGL <br /> (Exception:Oil&Grease,VOA and CrVI verified in lab] <br /> 4. VOAs checked for Headspace? es 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? s No <br /> Attach labels to the containers and include a copy of the COCb deli <br /> Sample Receipt, Login and Verification completed by (initials). <br /> Discrepancy Documentation: <br /> Any iteiIns 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. Pe'rson Contacted: (3017919) <br /> San loaquInitiated By: in EHD <br /> Problem: <br /> Resolution: STK2335191 <br /> (Please use the back of this sheet for addit iv 0412712023 07:17:40 -.r here <br /> contacts 11 TY2335191I11111111� <br /> > 1111111111 <br /> STK2335191 <br />
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