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ARCHIVED REPORTS_XR0009417
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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F
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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 Receinit Checklist <br /> Client Name: ATC A S SoC irtPS <br /> Date&Time Received: DSI 2o/ 0 3 j S.30 <br /> Project Name: S tock to vl L-2,'4 L Cart Client Project Number: S a (;-7 L . 6 O DZ <br /> Received By: C. Matrix: Water oil ! <br /> Sample Carrier: Client eborato I edEx I UPS I <br /> Argon Labs Project Number: <br /> Shipping Container/Cooler in good 0 clition? Samples received in proper containers? Yes f No <br /> WA Yes ✓ No Samples received intact? a -/ <br /> Y s No <br /> Samples received under refrigeration?/ Sufficient sample volume for requested tests? <br /> Yes �/ Nc Yes 'f No <br /> Chain of Custody Present? Yes ✓ No Samples received within holding time? Yes ✓ No <br /> Chain of Custody signed by all parties? Do samples contain proper preservative? <br /> Yes No NIA ✓Yes No <br /> Chain 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: <br /> ` Person Contacted: <br /> Contacted by: Subject: <br /> Comments: <br /> Action Taken. <br /> OTHER <br /> Date Client Contacted: Person Contacted: <br /> Comments: <br />
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