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ARCHIVED REPORTS_XR0009420
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_XR0009420
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Entry Properties
Last modified
12/11/2019 11:12:11 AM
Creation date
12/11/2019 9:47:45 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0009420
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
Tags
EHD - Public
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------------------ <br /> Ar on Laboratories Sample Receipt Checklist <br /> -=' Client Name: ATL tS Date 8 Time Received 07 1 fly <br /> Project Name: Stock}a-5rw;44 Cand Client Project Number. <br /> Received By. e- Matrix: Water oil I <br /> Sample Carrier:_-Client Laborato edEx 1 UPS I <br /> Argon Labs Project Number. <br /> Shipping ontainer 1 Cooler in good condition? Samples in proper containers? Yes No <br /> Yes 71 No N/A Samples received intact? Yes No <br /> Samples received under refrigeration? Sufficient s Moe volume for requested tests? <br /> Yes J No Yes Sufficient <br /> Chain of Custody Present? Yes ✓ No Samples received Wthin holding time? Yes ✓ No <br /> Chain of Custody signed by all parties? Do samples contain proper preservative? <br /> Yes ✓ No Yes No NIA <br /> Chainof custody matches ail sample labels? Do VOA vials contain zero headspace? <br /> Yes No Yes No (None submitted____) <br /> ANY "No" RESPONSE MUST BE DETAILED 1N THE COMMENTS SECTION BELOW <br /> - - . — . . — . . — . . . . — . . — . . — . . — . . — . . _ .. . . — . . — . . — . . — . <br /> 1s Date Client Contacted: 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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