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WP0044138
Environmental Health - Public
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4200/4300 - Liquid Waste/Water Well Permits
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WP0044138
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Last modified
8/5/2024 2:42:23 PM
Creation date
6/24/2024 7:56:30 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0044138
PE
4380
STREET_NUMBER
23685
Direction
N
STREET_NAME
TRETHEWAY
STREET_TYPE
RD
City
ACAMPO
Zip
95220-
APN
00738024
ENTERED_DATE
12/8/2022 12:00:00 AM
SITE_LOCATION
23685 N TRETHEWAY RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\gmartinez
Tags
EHD - Public
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FGL Environmental Doc ID:3DO900002_SOP_14.DOC <br /> Revision Date: 10/10/23 Page 1 of 1 <br /> Inter-Laboratory Condi ' n on Receipt (Attach to COC} nit",'I <br /> Sample Receipt at: CC CH T VI <br /> 1. Number of ice chests/packages received Shipping tracking#(s): <br /> 2. Temp IR Gun ID AdQ68+_ <br /> 3. Were samples received on ice? Yes No Tem : <br /> ps / <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 /> 4. Do the number of bottles received agree with the COC? No N/A <br /> 5. Were samples received intact? (i.e. no broken bottles, leaks etc.) No <br /> 6. VOAs checked for Headspace? Y No <br /> 7. Were all analyses within holding times at time of receipt? No <br /> 8. Verify sample date, time and sampler name No <br /> Sign and date the COC,place in a ziplock and p 'n ame ice chest as the samples. <br /> Sample Receipt Review completed by (initials): <br /> Sample Receipt at SP: , <br /> �t S C��� <br /> 1. Number of ice chests/packages received: Shipping tracking#(s): S � <br /> 2. Temp IR Gun ID #:TN'2-lam esTemps: ,; <br /> SY�7 <br /> 3. Were samples received on ice? YNo Temps: ,; <br /> Acceptable is above freezing to 6T. If many packages are received at one time check for tests/H.T.'s/rushes/ <br /> 4. Do the number of bottles received agree with the COC? �Yw No N/A <br /> 5. Were samples received intact?(i.e. no broken bottles, leaks etc.) Yv 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? QYw No <br /> 2. Did bottle labels correspond with the client's ID's? des No <br /> 3. Were all bottles requiring sample preservation properly preserved? Ye&/ No N/A FGL <br /> [Exception:Oil&Grease,VOA and CM verified in lab] <br /> 4. VOAs checked for Headspace? Yes No LNa <br /> 5. Have rush or project due dates been checked and accepted? Yes No _NA <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 delivery. <br /> Sample Receipt, Login and Verification completed by (initials): -7C_ <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: (3017919) <br /> San Joaquin CountyEHD <br /> (Please use the back of this sheet for additional comments or co STV438270 <br /> jaw 061061202416:58:11 <br /> OI I���llll�illa�llf�l�fllllllll <br /> STK2438270 <br />
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