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ARCHIVED REPORTS_XR0009417
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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FONTANA
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2130
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3500 - Local Oversight Program
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PR0545053
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ARCHIVED REPORTS_XR0009417
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Last modified
12/11/2019 11:27:39 AM
Creation date
12/11/2019 9:46:26 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0009417
RECORD_ID
PR0545053
PE
3528
FACILITY_ID
FA0005720
FACILITY_NAME
SMITH CANAL PUMP STATION
STREET_NUMBER
2130
STREET_NAME
FONTANA
STREET_TYPE
DR
City
STOCKTON
Zip
95204
CURRENT_STATUS
02
SITE_LOCATION
2130 FONTANA DR
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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SJGOV\wng
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EHD - Public
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Ar on Laboratories Sample Receipt Checklist <br /> Client Name: Date&Time Received: 1 1 63 LLL. r- <br /> Protect Name: vk," Client Project Number: 5 to Z 5-"9- DO 0 Z <br /> Received By: matrix: afar 1 Soil 1 <br /> Sample Carder: Client aborato FedEx 1 UPS 1 <br /> Argon Labs Project Number: _ 1 0(4 { 11 <br /> Shipping Container/Cooler in goodco ition? Samples received in proper containers? Yes ",/Mo <br /> NIA Yes No Samples received intact? Yeses No <br /> Samples received under refrigeration? Sufficient sample volume for requested tests? <br /> Yes ✓ No Yes,/ No <br /> Chain of Custody Present? Yes No Samples received within holding lime? Yes / No <br /> Chain of Custody signed by allparties?/ Do samples contain proper preservative? <br /> Yes ✓ No NIA Yes No <br /> Chain of Custody matches all sample Ibels? Do VOA vials contain zero headspace? <br /> Yes No (None submitted—)Yes s/ Na <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Dale Client Contacted: <br /> Person Contacted: <br /> Contacted by: Subject: <br /> Comments: <br /> Action Taken: <br /> OTHER <br /> Dale Client Contacted: Person Contacted: <br /> Comments: <br /> :i <br />
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