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ARCHIVED REPORTS XR0010010
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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ELEVENTH
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612
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3500 - Local Oversight Program
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PR0544794
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ARCHIVED REPORTS XR0010010
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Entry Properties
Last modified
11/19/2024 10:19:02 AM
Creation date
9/3/2019 2:12:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010010
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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Amon Laboratories Sample Receipt Checklist <br /> i <br /> Client Name Ground Zero Analysis Date&Time Received �-Y03/16104 1602 <br /> Project Name So za"Il LLC Client Project Number 450 <br /> Received By H C Matrix Water 0 Soil ❑ <br /> Sample Carrier Client Q Laboratory ❑ Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number E03341 <br /> Shipper Container in good condition? Samples received in proper containers? Yes 0 No ❑ <br /> NIA Yes ❑� No ❑ Samples received intact? Yes Q No ❑ <br /> Samples received under refrigeration? Yes ❑ No ❑ Sufficient sample volume for requested tests?Yes - No �P <br /> Cham of custody present? Yes No ❑ Samples received within holding time? Yes 21 No ❑ <br /> Cham of Custody signed by all parties? Yes 0 No ❑ Do samples contain proper preservative? <br /> NIA Yes ❑ No ❑ <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspaoe? <br /> Yes Q No ❑ (None submitted Yes ❑ No ❑ <br /> —-- -- ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted 0 3/,D7. Person Conacted A wn — <br /> Contacted By H Ckc.ill Subject Y,-. sso- I I L a-,6sr <br /> Comments n .o nod L79LS t I z b J.d no-4 1"e-GG;v` '1 L R r+.bcr 6 ++1c <br /> e. ,.A r It. r FJ <br /> s►,u�^ inc�, Cs.tc, �114t clots rot bvG.,'i` �e/0Te.,a 'teSttl a-i 1�h4t S�iR,f'Ie <br /> Action Taken iLcroSC, �t llr.stccl "'t 'Lcd 0.1 <br /> ADDITIONAL TEST(S)REQUEST!OTHER <br /> ------- -------- -- <br /> Contacted By v�-- & U —4 <br /> Date Time 9 30 AM <br /> Call Received By <br /> Comments <br /> TSa <br />
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