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ARCHIVED REPORTS XR0001814
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0508009
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ARCHIVED REPORTS XR0001814
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Entry Properties
Last modified
5/20/2019 2:25:25 PM
Creation date
5/20/2019 2:10:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001814
RECORD_ID
PR0508009
PE
2957
FACILITY_ID
FA0007882
FACILITY_NAME
ARCO #760
STREET_NUMBER
225
Direction
S
STREET_NAME
CHEROKEE
STREET_TYPE
LN
City
LODI
Zip
95240
APN
04314058
CURRENT_STATUS
01
SITE_LOCATION
225 S CHEROKEE LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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Tags
EHD - Public
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SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIENT NAME, DATE Received at Lab: fZ 7— (Drinlung water)for <br /> REC BY(PRINT) TIME Received at Lab: /Lm regulatory purposes. YESINO <br /> WORKORDER 7 Q LOG 1N DATE: 7 Z-q� (Wastewater)for <br /> regulatory purposes: YES/NO <br /> # CIRCLE THE APPROPRIATE RESPONSE LAB SAMPLE DATE <br /> SAMPLE# # CLIENT ID DESCRIPTION MATRIX SAMPLED CONDITION(ETC.) <br /> I Custody Seal(s) Present 4�en- <br /> 2 <br /> v L✓ _ � <br /> Intact/Chain-of-Custod res t I Absent* 4 <br /> 3 Traffic Reports or <br /> Packing List Present 1 en 4 <br /> 4 Airbill Airbtll/Sti er <br /> x <br /> Present <br /> 5 Aubill# <br /> 6 Sample Labels res t/Absent a <br /> 7 Sample IDs /Not Lasted <br /> o hairs-of-Custod <br /> 8 Sample Condition a <br /> t t/Broken*! <br /> 9 Does information on <br /> custody reports,traffic <br /> reports and sample <br /> labels agree? es No* <br /> 10 Sample received within <br /> hold time e /No* <br /> 11 Proper Preservatives <br /> used /No* <br /> , 12 Temp Rec at Lab <br /> (Acceptance range for samples <br /> ° re unrin thermal Rres 4f/-2°C) a/No* <br /> N� <br /> *If Circled, contact Project Manager and attach record of resolution. <br /> Sample Receipt Log <br /> Revision 21 (11110/00) <br /> JWPI.cEs Revision 2(11106/00) %Pageof <br /> l_ffectiae 102/00 <br />
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