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ARCHIVED REPORTS XR0006623
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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COUNTRY CLUB
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1403
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2900 - Site Mitigation Program
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PR0505513
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ARCHIVED REPORTS XR0006623
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Entry Properties
Last modified
6/21/2019 9:55:33 AM
Creation date
6/21/2019 9:12:52 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006623
RECORD_ID
PR0505513
PE
2950
FACILITY_ID
FA0006438
FACILITY_NAME
United # 5446
STREET_NUMBER
1403
Direction
W
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12323246
CURRENT_STATUS
02
SITE_LOCATION
1403 W COUNTRY CLUB BLVD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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r, <br /> STL i <br /> { STL San Francisco <br /> Sample Receipt Checklist <br /> Submission #:2004- <br /> i Checklist completed by (initials} Date {j104 i <br /> � Couner name' 0 3TL San Francesca © Ghent <br /> f Custody seals intact on shipping container/samples Yes No Prbtsent2 <br /> Chain of custody present? yes—Z No <br /> Chain of custody signed when relinquished and received' Yes-41—No <br /> r <br /> Chain of custody agrees with sample lsbel$? i Yes ✓ No <br /> I <br /> Samples in proper oontainer/bottle? Yes ✓No <br /> Sample containers intact? I Yes L--Mo <br /> Sufficient sample volume for endreated test? Yes!-No <br /> All samples received wdfiln holding time? Yes _t---No <br /> ContainerlTemp Blank temperature.In compliance(441 C�2p � Temp "t.�*C Yer,4 No <br /> Joe Present Yes_LNo <br /> i Water-VOA vials have zero hoadspece? No VOA vials i ubmitted Yes l.- No <br /> (if bubble is present, refer to approAmate bubble size.and itetntze ria comments as 5(�rrial�-C)), (msdkum 0)or L(large- V) <br /> Water-pH acceptable upon receipt" 0 Yes ❑No <br /> 13 pH adjusted-- Preservative used d'HNC,0 HC1 E]HZI l04❑NODH 0 ZnOAI,--IL##(s) <br /> i Fir any item check-listed "No",provided detail of discrepancy in Comment sec$an ow <br /> Comments. <br /> E <br /> Project Management-[Routinglor-insiruction pf indiogkiddisd6pan 006y11 <br /> 1prnject Manager. (initials) aete { 104 <br /> Client contacted ❑ Yes 0 No <br /> Summary of clascuta on <br /> r <br /> Oorrective Action(pier t'WClient) <br /> 1 <br /> t <br /> T <br /> I <br />
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