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ARCHIVED REPORTS XR0010015
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 XR0010015
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Entry Properties
Last modified
11/19/2024 10:19:02 AM
Creation date
9/3/2019 2:14:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0010015
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 /> . Client Name a� Date&Time Received 3 1 -S / 03 30 <br /> Profact Name syag: Client Project Number y5 <br /> Recaived By Matrix Water / Soil 1 <br /> Sample Camer Chen t abor o / FedEx I UPS 1 <br /> Argcn Labs Project Number 030 51 <br /> Shipping Container/Cooler in good condition? Samples received in proper containers? Yeses_. No <br /> N/A,k Yes No Samples received intact? Yes <br /> Samples received under refrigeration? Sutfic+ent sample volume for requested tests? <br /> Yes;_ No Yes k No <br /> Cham of Custody Present? Yes X No Samples received within holding time? Yes X No <br /> Cham of Custody signed by all parties? Do samples contain proper preservatjve? <br /> Yes No NIA Yes A— No <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yeses_ No (None submitted)Yes X No <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> -- - - - - - - - - - - . -- _ _ -- _ _ -- - - . . . -- - - -- _ _ _.. _ - - - - - - _ V <br /> Date Client Contacted Person Contacted <br /> Con acted by Subject <br /> Comments <br /> Actfon Taken <br /> OTHER <br /> Date Client Contacted Person Contacted <br /> Gorr men s ` <br />
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