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WP0043766
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0043766
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Entry Properties
Last modified
9/5/2023 11:50:15 AM
Creation date
7/20/2023 4:10:24 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0043766
PE
4370
STREET_NUMBER
241
Direction
W
STREET_NAME
JOSEPH
STREET_TYPE
RD
City
MANTECA
Zip
95336-
APN
21633048
ENTERED_DATE
9/14/2022 12:00:00 AM
SITE_LOCATION
241 W JOSEPH RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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SJGOV\gmartinez
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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-Labtory Condition Upon Receipt (Attach to COC)a9,�671� <br /> Sample Receipt at: K CC CH VI <br /> 1. Number of ice chess 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? �MNo No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) <br /> 5. VOAs checked for Headspace? Yes No QE� <br /> 6. Were sample custody seals intact? Yes No <br /> 7. If required, was sample split for pH analysis? Yes No <br /> 8. Were all analyses within holding times at time of receipt? No <br /> 9. Verify sample date,time and sampler name No <br /> Sign and date the COC,place in a ziplock and put in th ame 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 u C. If many packages are received at one time check for tesstts/H.T.'s/rushes/ <br /> 2. Shipping tracking numbers: ,s� �&C( SS Z�ti <br /> 3. Do the number of bottles received agree with the COC? LY�es/ No N/A <br /> 4. Were samples received intact? (i.e. no broken bottles, leaks etc.) Y.W 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 labels. <br /> Sample Verification, Labeling and Distribution: <br /> 1. Were all requested analyses understood and acceptable? (Ygs No <br /> 2. Did bottle labels correspond with the client's ID's? (.Y� No <br /> 3. Were all bottles requiring sample preservation properly preserved? ky..os No N/A FGL <br /> (Exception:Oil&Grease,VOA and CrVI verified in labl <br /> 4. VOAs checked for Headspace? Yes No /A <br /> 5. Have rush orJ ro'ect due dates been checked and accepted? Yes No <br /> P P <br /> 6. Were all analyses within holding times at time of receipt? Y& 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): t <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: (3017919) <br /> Resolution: San Joaquin CountyEHD <br /> (Please use the back of this sheet for additional com <br /> contacts) STC336732 <br /> iv 05/2512023 07:57:12 <br /> ISI Ili Il 11 1111111 l�lllllll�llil�ll l� <br /> STK2336732 <br />
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