My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS XR0006981
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
E
>
E
>
103
>
3500 - Local Oversight Program
>
PR0544638
>
ARCHIVED REPORTS XR0006981
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
7/9/2019 2:57:11 PM
Creation date
7/9/2019 2:21:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006981
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
Scanner
SJGOV\wng
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
29
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
i <br /> Alpha Analytical, Inc. <br /> �? Phone (775)355-1044 FAX (775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client 12123/2004 Date of Notice 1 211 512004 1-26 25 <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 2001-01031Teichert <br /> Project Manager Steve Carter Clients Phone (530) 676-6008 Client's FAX (530)676-6005 <br /> Work Order Number STR04121549 Date Received 1211512004 Received by Dally S Baker <br /> Chain of Custody COC Information <br /> Camer name FedEx <br /> Chain of custody present? Yes No <br /> Custody seals intact on shippping container/cooler? Yes ❑ No Not Present r <br /> Custody seals intact on sample bottles? Yes ❑ ❑ No Not Present <br /> Chain of custody signed when relinquished and received? Yes D ❑ No <br /> Crain of custody agrees with sample labels? Yes 0 ❑ No <br /> Sample ID noted by Client on COC? Yes W ❑ No <br /> Date and time of collection noted by Client on COC? Yes W ❑ No <br /> Samplers's name noted on COC? Yes R ❑ No <br /> Onternal Chain of Custody(COC)requested? Yes ❑ E-J-1 No V <br /> Sub Contract Lab Used None L-1/1 ❑ SEM Other(see comments) ❑ <br /> Sample Recei t Information <br /> Shipping container/cooler in good condition? Yes 0 ❑ No Not Present ❑ <br /> Samples in proper container/bottle? Yes U ❑ No <br /> Sample containers intact? Yes FI/I ❑ No <br /> Sufficient sample volume for indicated test? Yes W-1 ❑ No <br /> Sample Preservation and Hold Time HT Information <br /> All samples received within holding time? Yes No Cooler Temperature <br /> 4°C <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes Lv� J No <br /> Water-VOA vials have zero headspace/no bubbles? <br /> Yes R/I ❑ No No VOA vials submitted l <br /> Sample labels checked for correct preservation? Yes 1R.1 ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ ❑ No NIA �1 <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested ? Yes ❑ No <br /> Are there client specific Project requirements? Yes ❑ No If YES see the Chain of Custody(COC) <br /> Comments <br />
The URL can be used to link to this page
Your browser does not support the video tag.