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ARCHIVED REPORTS XR0004809
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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M
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MADISON
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420
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2900 - Site Mitigation Program
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PR0521765
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ARCHIVED REPORTS XR0004809
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Entry Properties
Last modified
5/6/2019 4:49:32 PM
Creation date
5/6/2019 4:34:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004809
RECORD_ID
PR0521765
PE
2950
FACILITY_ID
FA0014781
FACILITY_NAME
CARANDO MACHINE WORKS
STREET_NUMBER
420
STREET_NAME
MADISON
STREET_TYPE
ST
City
STOCKTON
Zip
95202
CURRENT_STATUS
01
SITE_LOCATION
420 N MADISON ST
P_LOCATION
01
QC Status
Approved
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SJGOV\wng
Tags
EHD - Public
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SOP Volume Client Services ' <br /> Section 1 12 <br /> Page I of 1 <br /> Effective Date 10-May-99 cb <br /> Curtis &Tompkins Ltd <br /> Revision I Number 1 of 3 <br /> Filename F 1QC\FormsIQC\Cooler wpd <br /> COOLER RECEIPT CHECKLIST <br /> l —�7- a <br /> Logih# I ` [ Date Received ( L( Number of Coolers ' <br /> Client `C" weld Project <br /> A Preliminary Examination Phase ' <br /> Date Opened -M tf-0 By (print) 7r y W(J5oV' (sign) <br /> 1 Did cooler come with a shipping slip (airbill, etc )? YES O ' <br /> ' If YES, enter carrier name and airbiII number <br /> 2 Were custody seals on outside of cooler? YESO , <br /> How many and where? Seal date Seal name <br /> 3 Were custody seals unbroken and intact at the date and time of arrival? YES NO <br /> -WIA <br /> 4 Were custody papers dry'and intact when received? r3D NO ' <br /> 5 Were custody papers filled out properly (ink, signed, etc )? <SM NO <br /> 6 Did you sign the custody papers in the appropriate place? <21�9 NO <br /> 7 Was project identifiable from custody papers? r(a NO , <br /> If YES, enter project name at the top of this form <br /> 8 If required, was sufficient ice used? Samples should be 2-6 degrees rrC YE NO <br /> Type of ice �/ �- _- Temperature <br /> B Login.Phase W'JSnqsign)_DateLoggedIn -� n� By(print) ' <br /> 1 Describe type of packing in cooler Z� G <br /> 2 Did all bottles arrive unbroken? NO <br /> 3 Were labels in good condition and complete (ID, date, time, signature, etc )? 4�R NO ' <br /> 4 Did bottle labels agree with custody papers? IM NO <br /> 5 Were appropriate containers used for the tests indicated? eSUS NO <br /> 6 Were correct preservatives added to samples? YES NO 1111A ' <br /> 7 Was sufficient amount of sample sent for tests indicated? NO <br /> 8 Were bubbles absent in VOA samples?If NO, list sample Ids below YES NO IV'14 ' <br /> 9 Was the client contacted concerning this sample delivery? YES NO <br /> If YES, give details below <br /> Who was called? By whom? Date ' <br /> Additional Comments <br /> 1 <br /> 1 <br /> Filename F lgcVormslgcicooler doc Rev 1,4195 <br />
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