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ARCHIVED REPORTS XR0000767
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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CAMBRIDGE
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16470
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3500 - Local Oversight Program
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PR0544155
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ARCHIVED REPORTS XR0000767
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Entry Properties
Last modified
2/15/2019 3:50:06 PM
Creation date
2/15/2019 2:02:47 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000767
RECORD_ID
PR0544155
PE
3526
FACILITY_ID
FA0000185
FACILITY_NAME
CITY GAS & LIQUOR
STREET_NUMBER
16470
STREET_NAME
CAMBRIDGE
STREET_TYPE
ST
City
LATHROP
Zip
95330
APN
19643032
CURRENT_STATUS
02
SITE_LOCATION
16470 CAMBRIDGE ST
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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-ST-L <br /> STL Sart Francisca <br /> f Saa/mple Receipt Checklist-r <br /> Submission #:2003- ! - 0 -3-T <br /> Checklist b completed Date 1b 1 � / 103 <br /> p y (1 nitials} <br /> Couper name M STI.San Francisca ❑ Client <br /> Not <br /> Custody seats Intact on shipping cprilainerfsamplas Yes N Present L--- <br /> Chain of custody present? Yes-1:::f% <br /> Chain of custody signed when relinquished and received? Yes____L,,,Nq <br /> Chain of custody agrees with sample labels`? Yes No <br /> Samples In proper containertbottle? Yes <br /> Sample containers intact? Yes --�No <br /> Sufficsent sample volume for indicated test? Yi's No <br /> All samples recelved within holding time? 4,1/ Yes -.",eNo <br /> Container/Temp Blank temperature In compliance(4°C 12)? T p_ r '4t Yes,Z'NO <br /> toe Present Yes-�a <br /> Water- VOA vials have zero headspace? No VQA vials& bmitted Yeses No.__ <br /> ff bubble is present, refer to apprmdmate bubble size and itemize in comments as S`(smali~0)I M(medium- a)or L(lprge 0) <br /> Water-pH acceptable upon receipt2 es a No <br /> 13 pH adjusted- Preservative used ❑ HNO3 0 HCI&�H2$04 fl NaOH❑ZnOAa-t at#(st) <br /> For any Item check-listed "No",prQvtded delaii of dis6repaKty in rommeant section below. <br /> Comments: <br /> Proje'ot Management [Routing,fe)Hnslructton of indicated dis`crepan (ie)f <br /> Prolict Manager,(itittia)s) Date 1 103 <br /> CCent contacted. Q Yes ❑' No <br /> Summarypt d=ussion. <br /> Cofreio Aetipn(per PM/Client) <br /> k <br /> e[� <br /> C — <br /> I � l <br />
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