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COMPLIANCE INFO_10/7/24 SITE CHARACTERIAZTION RPT
Environmental Health - Public
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EHD Program Facility Records by Street Name
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4400 - Solid Waste Program
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PR0504909
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COMPLIANCE INFO_10/7/24 SITE CHARACTERIAZTION RPT
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Entry Properties
Last modified
10/25/2024 11:10:33 AM
Creation date
10/25/2024 9:52:15 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4400 - Solid Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
10/7/24 SITE CHARACTERIAZTION RPT
RECORD_ID
PR0504909
PE
4430 - SOLID WASTE CIA SITE
FACILITY_ID
FA0006400
FACILITY_NAME
RIVERBANK CITY DUMP
STREET_NUMBER
0
STREET_NAME
SANTA FE
STREET_TYPE
RD
City
RIVERBANK
Zip
95367
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\cfield
Supplemental fields
Site Address
SANTA FE RD RIVERBANK 95367
Tags
EHD - Public
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SAMPLE RECEIPT CHECKLIST -r tI9r^lSection 1: General lnfo <br />Date Received t8122124 VilgX 514512 qlis61. CONDOR EARTH INIHAll'Y <br />Section 2: Shipping / Custody <br />Custody seals intact on arrival? A N/A 3 Yes E No <br />Are custodyseals present?E Yes E No <br />- On cooler/ box E On samples <br />Shipping lnfo <br />Sestion 3a: Condition / Packaging E Outside 0.0 - 6.0'C (0.0 - 10.0'C for microbiology) (PM notified) <br />Date opened 8122124 By (initials)GCK Type of ice used : E Wet n Blue/Gel E None <br />E Samples received on ice directly from the field; cooling process had begun. (if checked, skip temperatures) <br />E Sample matrix doesn't require cooling (e.g. air, bulk PCB). (if checked, skip temperatures) <br />lf no cooler: Observed/Adjusted Temp (Cl _l Thermometer/lR Gun: lR01 CF:-0.6 <br />CooterTemp (c)#t:5-2 la.6 42'4.8 /4.2 $: / ff4 I #5: / #6: I <br />Sestion 3b: Microbiology Samples <br />tr Within temp range 0.0 - 10.0'C or received on ice directly from field <br />0 Adequate headspace for microbiology analysis. <br />I No microbiology samples submitted (skip 3b) <br />Section 3c: Air Samples <br />E f .AL Canisters E 6L Canisters E)Tedlar Bags <br />I No air samples submitted (skip 3c) <br />E ucr cassettes fl Sorbent Tubes fl other <br />Sectlon 4: Contalners / Labels / Samples YES NO N/A <br />1) Were custody papers present, filled properly, and legible?x <br />2) ls the sampler's name present on the CoC?x <br />3) Were containers received in good condition (unbroken / unopened / uncompromised)?x <br />4) Were the samples bagged? (required for microbiology samples; recommended for soil samples)x <br />5) Were all of, and only, the correct samples received?x <br />5) Are sample labels present, legible, and in agreement with the CoC?x <br />7) Does the container count match the CoC? <br />8) Was sufficient sample volume / mass received for the analyses requested? <br />x <br />x <br />9) Were samples received in proper containers for the analyses requested?x <br />10) Were samples received with > t/2 holding time remaining?x <br />11) Are samples properly preserved as indicated by CoC / labels?x <br />12) Unpreserved VOAs received - lf necessary, was the hold time changed in LIMS?x <br />13) Are VOA vials free from headspace/bubbles > 6mm?x <br />Section 5: Explanations / Comments E PM notified <br />Date Logged By <br />By <br />BLH LY <br />Date Labeled SEC <br />Enthalpy Analytical J-0005, Rev 2: Form Version 16.1081224 <br />8t21124 <br />81211% <br />10 of 95
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