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ARCHIVED REPORTS XR0011890
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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7675
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3500 - Local Oversight Program
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PR0544802
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ARCHIVED REPORTS XR0011890
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Entry Properties
Last modified
11/19/2024 10:19:08 AM
Creation date
9/4/2019 11:46:20 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011890
RECORD_ID
PR0544802
PE
3528
FACILITY_ID
FA0005153
FACILITY_NAME
FAYETTE MANUFACTURING CORP
STREET_NUMBER
7675
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
25014012
CURRENT_STATUS
02
SITE_LOCATION
7675 W ELEVENTH ST
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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SJGOV\wng
Tags
EHD - Public
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f <br /> Amon Laboratories Sample Receipt Checklist <br /> Client NameZC b�6(1)'a <br /> y�OQ Date&Time Received: <br /> ..1//� Q <br /> Project Name: V(� Client Project Number:t 7�1 748 <br /> Received By: t � Matrix: Water Soil ❑ Other <br /> Sample Carder: Client ¢ <br /> ❑ Laboratory I"J Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number: <br /> Shipper Container in good condition? Sufficient samplevolume for requested tests?Yes No ❑ <br /> N/A P/ Yes El No ❑ Samples received within holding time? Yes No ❑ <br /> Samples received under refrigeration? Yes No ❑ Do samples contain proper preservative? �/ <br /> N/A ❑ Yes Uy No ❑ <br /> Chain of custody present? Yes No ❑ VOA vials with preservative? <br /> N/A ❑ Yes [J� No ❑ <br /> Chain of Custody signed by all parties? Yes No <br /> ❑ VOA vials preservative type: <br /> HCL d Na2S203 ❑ Other <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes No ❑ N/A ❑ Yes Q/ No ❑ <br /> Samples received in proper containers? Yes [v� No ❑ Samples received intact? - Yes No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> ------------------ ------------- <br /> Date Client Contacted: <br /> Person <br /> Contacted: <br /> Contacted By: Subject: <br /> Comments: <br /> Action Taken: <br /> ADDITIONAL TEST(S)REQUEST 1 OTHER <br /> Contacted By: Date: Time. <br /> Call Received By: <br /> Comments: <br /> V <br /> v.5.02 <br /> i <br />
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