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SR0081206 SSNL
EnvironmentalHealth
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2600 - Land Use Program
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SR0081206 SSNL
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Entry Properties
Last modified
12/26/2019 2:14:29 PM
Creation date
12/26/2019 1:59:47 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0081206
PE
2602
FACILITY_NAME
CALIFORNIA ISLAMIC CENTER
STREET_NUMBER
12882
Direction
N
STREET_NAME
LOWER SACRAMENTO
STREET_TYPE
RD
City
LODI
Zip
95242
APN
05807023
ENTERED_DATE
9/26/2019 12:00:00 AM
SITE_LOCATION
12882 N LOWER SACRAMENTO RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
TSok
Tags
EHD - Public
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Page 8 of 8 <br /> WORK ORDER #: i 0-0w,'-[N ® E <br /> • C oolelr N of <br /> CLIENT: DATE: 07 1\'�> 11O <br /> TEMPERATURE: Thermometer ID: SCI (Criteria: 0.0°C-6.0°C, not frozen) <br /> Temperature OC + 0.5°C (CF) = 2 • 8' -OC <br /> , wank 0 Sample <br /> ❑ Sample(s)outside temperature criteria(PM/APM contacted by:__ _�• <br /> ❑ Sample(s)outside temperature criteria but received on ice/chilled on same day of samp ing. <br /> ❑ Received at ambient temperature, placed on ice for transport by Courier. <br /> Ambient Temperature. ❑ Air 13 Filter 13 Metals Only ❑ PCBs Only Initial: <br /> CUSTODY SEALS INTACT: <br /> ❑'Cooler ❑ ❑ No(Not Intact) ❑ ,No Present ❑ N/ Initial: ? <br /> El Sample o ❑ No(Not Intact) ;KNot Present Initial: <br /> FSAMPLcECONDITION: Yes No NIA <br /> ustody(COC) documents) received with samples...................ments) received complete................................................... 2 ❑ ❑ <br /> ❑ CoNection date/time.matrix,and/or#of containers logged in based on sample labels. <br /> ❑ No analysis requested. Cl Not relinquished. ❑ No date/time relinquished. <br /> Sampler's name Indicated on COC.........., <br /> ................... <br /> Sample container labei(s) consistent with COC............ .•••. ❑ ❑ <br /> ............. .. . <br /> Sample container(s) intact and good condition...................................... �'� ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested............... ❑ ❑ <br /> Analyses received within holding time..................... •• ❑ ❑ <br /> ........................ . <br /> pH/ Residual Chlorine I Dissolved Sulfide received within 24 hours........... ❑ ❑ <br /> Proper preservation noted on COC or sample container.......................... © ❑ <br /> ❑ Unpreserved vials received for Volatiles analysis <br /> Volatile analysis container(s)free of headspace..................... <br /> Tedlar bag(s)free of condensation............ ....... ................I [-_] <br /> ❑ <br /> CONTAINER TYPE: <br /> Solid: 04ozCGJ 1D8a ,G.1 016ozCGJ ❑Sleeve (,) ❑EnCores® ❑T aCores® L7 <br /> Water: ❑VOA ❑VOAh�11/OAna2 0125AGB 0125AGBh ❑125AGBp 17-11AG ❑1AGBna2 01AGBs <br /> 0500AGB 0500AGJ 0500AGJs 0250AGB 11250CGB ❑250CGBs ❑1PB 0500PB 0500PBna <br /> 0250PB ❑250PBn ❑125PB 0125PBznna ❑100PJ 0100PJna2 ❑ 11 ❑ <br /> Air: ❑Tedlaro ❑Summa° Other- ❑ Trip Blank Lot#: Label d/Checked by: <br /> Container: c:clear A Amber P:Plastic G:Glass J:Jar B:BoWe z:Z]ploclResealable Bag E:Envelope Reviewed by: <br /> Preservative: fi:HCL n:HNO3 nae:Na2SA na:NaOH p:H3PO4 s:H2SO4 znna:ZnAcz+NaOH f:Ftekt-fitter Scanned by: <br /> SOP TioD_090(asion0) <br />
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