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ARCHIVED REPORTS Second Quarter 2012
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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ALPINE
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2900 - Site Mitigation Program
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PR0526874
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ARCHIVED REPORTS Second Quarter 2012
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Last modified
11/1/2018 2:33:09 PM
Creation date
11/1/2018 8:52:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS Second Quarter 2012
FileName_PostFix
Second Quarter 2012
RECORD_ID
PR0526874
PE
2960
FACILITY_ID
FA0018201
FACILITY_NAME
FORMER MOBIL SERVICE STATION 99-CAS
STREET_NUMBER
75
Direction
E
STREET_NAME
ALPINE
STREET_TYPE
AVE
City
STOCKTON
Zip
95204
APN
11514007
CURRENT_STATUS
01
SITE_LOCATION
75 E ALPINE AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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Tags
EHD - Public
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Page 11 of 11 <br />WORKORDER .4 12o.064DMEL <br />4122MOMEBox 1 of ( .. <br />CLIENT: CAA4yUn &P-1 _ DATE: 06 log / 12 <br />TEMPERATURE: Thermometer ID: SC2 (Criteria: 0.0 °C — 6.0 °C, not frozen) <br />Temperature •� OC- 0.30C (CF) _ °C ❑Blank ❑Sample <br />❑ Sample(s) outside temperature criteria (PWAPM contacted by: �. <br />❑ Sample(s) outside temperature criteria but received on ice/chilled on same day of sampling. <br />❑ Received at ambient temperature, placed on ice for transport by Courier. <br />Ambient Temperature: 2fAir ❑ Filter Initial: <br />CUSTODY SEALS INTACT: <br />❑ Box ❑ ❑ No (Not Intact) Z"Not Present ❑ N/A Initial: <br />❑ Sample ❑ ❑ No (Not Intact) P'l lot Present Initial: <br />SAMPLE CONDITION: Yes <br />No <br />N/A <br />Chain "Of -Custody (COC) document(s) received with samples ................... <br />2f.*** <br />❑ <br />❑ <br />COC document(s) received complete ................................................... <br />❑ <br />-� <br />❑ <br />❑ Collection date/time; matrix, -and/or # of containers logged in based on sample labels. <br />o date/time relinquished. <br />❑ No analysis requested. ❑ Not relinquished. <br />Sampler's name indicated on COC ..................................................... <br />❑ <br />❑ <br />Sample container label(s) consistent with COC ..................................... <br />❑ <br />❑ <br />Sample container(s) intact and good condition ...................................... <br />42r <br />❑ <br />❑ <br />Proper containers and sufficient volume for analyses requested ............... <br />❑ <br />❑ <br />Analyses received within holding time.. ........... ............................... <br />'❑ <br />❑ <br />pH / Res. Chlorine / Diss. Sulfide / Diss. Oxygen received within 24 hours... <br />❑ <br />❑ <br />Lill' <br />Propet preservation noted on COC or sample container .......................... <br />❑ <br />❑ <br />L <br />❑ Uhpreserved vials received for Volatiles analysis <br />Volatile analysis container(s) free of headspace:.................................... <br />❑ <br />❑ <br />❑ <br />Tedlar bag(s) free of condensation.%.................................................... <br />❑ <br />CONTAINER TYPE: <br />Solid: 04ozCGJ 08ozCGJ 016ozCGJ ❑Sleeve C _ ) ❑EnCores® ❑TerraCorese ❑_____ <br />Water; ❑VOA ❑VOAh OVOAna2 ❑ 125AGB ❑ 125AGBh ❑ 125AGBp ❑ 1 AGB ❑ 1AGBna2 ❑ 1AGBs <br />0500AGB 0500AGJ ❑500AGJs 0250AGS 0250CGB 11250CGBs ❑1PB 01PBna 0500PB <br />0250PB 0250PBn 0125PB 0125PBznno 0100PJ 0100PJna2 ❑___ ...„ ❑,. ;, , ❑ <br />Air: edlar® ❑Summae Other: ❑_ _ Trip. Blank Lot# �LabeledJChecked by: <br />Container: C: Clear A: Amber P: Plastic ©: Glass J: Jar B: Bottle Z, Ziploc/Resealable Bag 6: Envelope Reviewed byt <br />Preservative: h: HCL n: HN o, na=:Nana: NaOH p: H9PO4 s: H2SO4 u: Ultra -pure zona: ZnAci+NaOH h Filtered Scanned by: <br />5UPTI11V_UVU41AM 71J <br />
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