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ARCHIVED REPORTS XR0006960
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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3500 - Local Oversight Program
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PR0544638
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ARCHIVED REPORTS XR0006960
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Entry Properties
Last modified
7/9/2019 2:40:55 PM
Creation date
7/9/2019 2:11:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006960
RECORD_ID
PR0544638
PE
3528
FACILITY_ID
FA0004027
FACILITY_NAME
HENDRIX FORK LIFT INC
STREET_NUMBER
103
Direction
N
STREET_NAME
E
STREET_TYPE
ST
City
STOCKTON
Zip
95205
APN
15318001
CURRENT_STATUS
02
SITE_LOCATION
103 N E ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\wng
Tags
EHD - Public
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Alpha Analytical, Inc. <br /> Phone: (775)355-1044 FAX:(775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client: 12124/02 Date of Notice: 12/16/02 11:43:40 A <br /> Please take note of any NO check marks.If we receive no response concerning these items within 24 hours of the date of this notice,all of <br /> the samples will be analyzed as requested. <br /> Client Name Stratus Environmental Project ID: 2001-0103freichert <br /> Project Manager: Steve Carter Client's Phone (530)676-6001 Client's FAX (530)676-6005 <br /> Work Order Number: STR02121604 Date Received:12114102 Received by: Heidi Eskew <br /> Chain of Custody(COC?Information <br /> Carrier name: FedEx <br /> Chain of custody present? Yes No <br /> Custody seals intact on shippping container/cooler? Yes ❑ No Not Present <br /> Custody seals intact on sample bottles? Yes ❑ ❑ No Not Present <br /> Chain of custody signed when relinquished and received? Yes ❑ No <br /> Chain of custody agrees with sample labels? Yes ❑ No <br /> Internal Chain of Custody(COC)requested? Yes ❑ No <br /> Sub Contract Lab Used: None ❑ SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> Shipping containerlcooier in good condition? Yes ❑ No Not Present 1-1 <br /> Samples in proper container/bottle? Yes 5 ❑ No <br /> Sample containers intact? Yes ❑ No <br /> Sufficient sample volume for indicated test? Yes ❑ No <br /> Sample Preservation and Hold Time H Information <br /> All samples received within holding time? Yes ❑ No Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? <br /> Yes ❑ No VC <br /> Water-VOA vials have zero headspace/no bubbles? Yes ® ❑ No No VOA vials submitted ❑ <br /> TOC Water-pH acceptable upon receipt? Yes ❑ ❑ No N/A <br /> TOC Samples should have a pH<2(H2SO4) <br /> Analytical Re ulrement Information <br /> Are non-Standard or Modified methods requested 7 Yes ❑ ® No <br /> Are there client specific Project requirements? Yes .❑ ® No If YES :see the Chain of Custody(COC) <br /> Comments ; <br /> • <br />
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