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ARCHIVED REPORTS XR0010011
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 XR0010011
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Entry Properties
Last modified
11/19/2024 10:19:02 AM
Creation date
9/3/2019 2:13:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010011
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
Scanner
SJGOV\wng
Tags
EHD - Public
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4 � <br /> {1 <br /> Ar on Laboratories Sample Receipt- Checklist <br /> Client Name Ground Zero Analysis Date&Time Received 12/16/2003 1500 <br /> Protect Name Souza's 11 LLC Client Protect Number 450 <br /> Received By D S Matrix Water 0 Soil ❑ <br /> i <br /> Sample Carrier Client Q Laboratory ❑ Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Protect Number D12441 <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 0 No ❑ Sufficient sample volume for requested tests?Yes ❑ No ❑ <br /> Chain of custody present? Yes No ❑ Samples received within holding time? Yes No ❑ <br /> Cham of Custody signed by all parties? Yes Q No ❑ Do samples contain proper preservative? <br /> NIA ❑ Yes El No ❑ <br /> Cham 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 IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted T` Person Canacted ^` <br /> Contacted By Subject <br /> Comments <br /> Action Taken <br /> ADDITIONAL TEST(S)REQUEST I OTHER <br /> Contacted By Date Time <br /> Call Received By <br /> Comments <br />
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