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ARCHIVED REPORTS XR0010009
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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ELEVENTH
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3500 - Local Oversight Program
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PR0544794
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ARCHIVED REPORTS XR0010009
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Last modified
11/19/2024 10:19:02 AM
Creation date
9/3/2019 2:12:27 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010009
RECORD_ID
PR0544794
PE
3528
FACILITY_ID
FA0013337
FACILITY_NAME
SOUZA II LLC (VACANT LOT)
STREET_NUMBER
612
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
23439018
CURRENT_STATUS
02
SITE_LOCATION
612 W ELEVENTH ST
P_DISTRICT
005
QC Status
Approved
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SJGOV\wng
Tags
EHD - Public
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r Ar on Laboratories Sam le Receipt Checklist <br /> Client Name Ground Zero Analysis _ Date&Time Received 3/30/2004 1345 <br /> Project Name Souza II Client Project Number 450 <br /> Received By P H Matrix Water 0 Soli ❑ <br /> Sample Carrier Client El Laboratory ❑ Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number E03661 <br /> Shipper Container in good condition? Samples received in proper containers? Yes ] No ❑ <br /> NIA Yes ❑ No ❑ Samples received intact? Yes No ❑ <br /> Samples received under refrigeration? Yes Q No ❑ Sufficient sample volume for requested tests?Yes Q No ❑ <br /> Chain of custody presents Yes ❑ No ❑ Samples received within holding time'? Yes ❑ No ❑ <br /> Chain of Custody signed by all parties? Yes ❑ No ❑ Do samples contain proper preservative <br /> NIA ❑ Yes ED No ❑ <br /> Chain of Custody matches all sample labels') Do VOA vials contain zero headspace) <br /> Yes 0 No ❑ (None submitted ❑) Yes ❑ No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> • Date Client Contacted Person Conacted <br /> Contacted By Subject <br /> Comments <br /> Action Taken <br /> ADDITIONAL TESTIS)REQUEST/OTHER <br /> Contacted By Date Time <br /> Call Received By <br /> Comments <br />
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