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2900 - Site Mitigation Program
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PR0539716
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Last modified
2/11/2019 4:22:59 PM
Creation date
2/11/2019 3:32:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0539716
PE
2950
FACILITY_ID
FA0022723
FACILITY_NAME
WALDO ROSE STORAGE
STREET_NUMBER
1919
Direction
N
STREET_NAME
BROADWAY
STREET_TYPE
AVE
City
STOCKTON
Zip
95205
APN
14315001
CURRENT_STATUS
01
SITE_LOCATION
1919 N BROADWAY AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> McCampbell Analytical, Inc. Toll Free Telephone:(877)252-9262/Fax:(925)252-9269 <br /> f "When Quality Counts" littp://www.inecainpbell.com/E-mail:main nrccampbell.com <br /> Sample Receipt Checklist <br /> Client Name: AEI Consultants Date and Time Received: 1/6/2015 7:03:10 PM <br /> Project Name: #337833;Waldo Rose Storage Logln Reviewed by: Agustina Venegas <br /> WorkOrder Ng: 1501074 Matrix: Water Carrier: Client Drop-In <br /> Chain of Custody(COCl Information <br /> Chain of custody present? Yes 0 No❑ <br /> Chain of custody signed when relinquished and received? Yes W No❑ <br /> Chain of custody agrees with sample labels? Yes No❑ <br /> Sample IDs noted by Client on COC? Yes No❑ <br /> Date and Time of collection noted by Client on COC? Yes No❑ <br /> Sampler's name noted on COC? Yes ❑✓ No❑ <br /> Samole Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA❑� <br /> Shipping container/cooler in good condition? Yes No❑ <br /> Samples in proper containers/bottles? Yes No❑ <br /> Sample containers intact? Yes 0 No❑ <br /> Sufficient sample volume for indicated test? Yes ❑.I No❑ <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? Yes 0 No❑ <br /> Sample/Temp Blank temperature Temp: 14°C NA❑ <br /> Water-VOA vials have zero headspace/no bubbles? Yes No❑ NA❑ <br /> Sample labels checked for correct preservation? Yes 0 No❑ <br /> pH acceptable upon receipt(Metal:<2;522:<4;218.7:>8)? Yes ❑ No❑ NA❑� <br /> Samples Received on Ice? Yes No❑ <br /> (Ice Type: WET ICE ) <br /> UCMR3 Samples: <br /> Total Chlorine tested and acceptable upon receipt for EPA 522? Yes ❑ No❑ NA❑�/ <br /> Free Chlorine tested and acceptable upon receipt for EPA 218.7, Yes ❑ No❑ NA❑� <br /> 300.1,537,539? <br /> NOTE:If the"No"box is checked,see comments below. <br /> --------------------------------------------- <br /> Comments: <br /> Page 18 of 18 <br />
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