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FIELD DOCUMENTS CASE 2
EnvironmentalHealth
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2900 - Site Mitigation Program
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PR0544726
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FIELD DOCUMENTS CASE 2
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Last modified
8/1/2019 4:32:12 PM
Creation date
8/1/2019 3:57:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
FileName_PostFix
CASE 2
RECORD_ID
PR0544726
PE
3528
FACILITY_ID
FA0003964
FACILITY_NAME
LODI PUBLIC SAFETY BUILDING
STREET_NUMBER
230
Direction
W
STREET_NAME
ELM
STREET_TYPE
ST
City
LODI
Zip
95240
APN
04303109
CURRENT_STATUS
02
SITE_LOCATION
230 W ELM ST
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Ar on Laboratories Sam le Re <br /> ce�N# Checklist <br /> Client Name: Ground Zero Analysis Date&Time Received: 4/7/2005 <br /> Project Name: Lodi Tire ---------- 16:10 <br /> Client Project Number: 664 <br /> Received By P.H. Matrix WaterED❑ Soil <br /> Sample Carrier, Client 21 Laboratory ❑ Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number. F04251 <br /> Shipper Container In good condition? <br /> Samples received in proper containers? Yes Q No ❑ <br /> WA Yes No ❑ Samples received intact? <br /> Yes [] No ❑ <br /> Samples received under refrigeration? yes ❑ No ❑ Sufcient sample volume for requested tests?Yes Q No <br /> Chin of custody present? yes ❑ ❑ ❑ <br /> No Samples received within holding time? Yes No ❑ <br /> Chain of Custody signed by all parties? Yes Q No ❑ Do samples contain proper preservative? <br /> WA ❑ Yes No ❑ <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes No ❑ (None submitted ❑) Yes No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED W THE COMMENTS SECTION BELOW <br /> Date Client Contacted: Person Contacted: <br /> Contacted By: Subject <br /> Comments: <br /> Action Taken: <br /> ADDITIONAL TEST(S)REQUEST/OTHER <br /> Contacted By: Date: Time: <br /> Call Received By: <br /> Comments: <br /> L . <br /> G-3 <br />
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