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ARCHIVED REPORTS XR0007245
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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WATERLOO
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6732
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3500 - Local Oversight Program
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PR0544809
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ARCHIVED REPORTS XR0007245
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Last modified
9/5/2019 11:43:02 AM
Creation date
9/5/2019 11:35:40 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007245
RECORD_ID
PR0544809
PE
3526
FACILITY_ID
FA0004030
FACILITY_NAME
THREE PALMS GROCERY
STREET_NUMBER
6732
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
10110001
CURRENT_STATUS
02
SITE_LOCATION
6732 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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� u <br /> Argon Laboratories Sample Receipt Checklist <br /> Client Name ATC Associates, Inc Date&Time Received 11712004 1600 <br /> Protect Name Bozzano Property Client Protect Number 54 14885 0001 <br /> Received By HC Matrix Water [f Soil ❑ <br /> Sample Carrier Client ❑ Laboratory Q Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Protect Number E01121 <br /> Shipper Container in good condition? Samples received in proper containers? Yes 0 No ❑ <br /> N!A Yes Q No ❑ Samples received intact? Yes No ❑ <br /> Samples received under refrigeration? Yes ❑ No ❑ Sufficient sample volume for requested tests?Yes ❑ No ❑ <br /> Chain of custody present? Yes 0 No ❑ Samples received within holding time? Yes 21 No ❑ ` <br /> Chain of Custody signed by all parties? Yes [ No ❑ Do samples contain proper preservative? <br /> NIA ❑ Yes No ❑ <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace) <br /> Yes Q 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 TEST(S)REQUEST I OTHER <br /> Contacted By Date Time <br /> i <br /> Call Received By <br /> Comments <br />
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