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ARCHIVED REPORTS XR0003425
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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COUNTRY CLUB
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2705
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3500 - Local Oversight Program
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PR0544595
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ARCHIVED REPORTS XR0003425
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Last modified
6/24/2019 11:32:24 AM
Creation date
6/24/2019 11:02:07 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003425
RECORD_ID
PR0544595
PE
3528
FACILITY_ID
FA0002048
FACILITY_NAME
TESORO (Shell) 68221(WRR 6290)
STREET_NUMBER
2705
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12121008
CURRENT_STATUS
02
SITE_LOCATION
2705 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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' HOUSTON LABORA <br /> 8880 INTERCHANGE DRIVE <br /> ® HOUSTON TX 77054 <br />' (713)660 0901 <br /> Sample Receipt Checklist <br /> Workorder 01080655 Received By NB <br /> Date and Time Received 8/18/01 9 30 00 AM Carrier name FedEx <br />' Temperature -- g - -- — -- ---- - -- -- - - <br /> Chilled by Water Ice <br /> 1 Shipping container/cooler in good condition9 Yes No Not Present <br /> Custody seals intact on shi — <br /> 2 in container/cooler?� <br /> ppp 9 ooler Yes —i No T; Not Present <br /> 3 Custody seals intact on sample bottles' Yes No! Not Present di <br /> 4 Chain of custody present? Yes No <br />' S Chain of custody signed when relinquished and received) Yes d' No <br />' 6 Chain of custody agrees with sample labels? Yes W No <br /> 7 Samples in proper container/bottle? Yes V, No_7 <br /> Sample containers intact? Yes <br /> No — <br />' 9 Sufficient sample volume for indicated test? Yes V-1 No <br /> 10 All samples received within holding time? Yes V No <br />' 11 ContainerlTemp Blank temperature in compliance' Yes d No L <br />' 12 Water-VOA vials have zero headspace7 Yes 71 Nov Not Applicable <br /> 13. Water-pH acceptable upon receipt' Yes —,;F, No _, Not Applicable I <br /> SPL Representative West Sonia _ _ Contact Elate &Time 8/20/01 1 50 00 PM <br /> Client Name Contacted John Ortega- <br /> Non Conformance 1 Client sent two sets of vials with the same Sx Id#MW-8 The only way to tell them apart are the times but none are _ <br /> Issues written on COC One set:s for 8/16/01 @13 10 and the other set is for 8/16/01 Q 13 25 - — <br /> Client Instructions 1 i oggod in both samples on hold until further notice <br /> I <br />
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