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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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G
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GRANT LINE
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340
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3500 - Local Oversight Program
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PR0545199
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Last modified
1/17/2020 9:28:11 AM
Creation date
1/17/2020 8:34:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545199
PE
3528
FACILITY_ID
FA0005789
FACILITY_NAME
JUANITA MARKET #4
STREET_NUMBER
340
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
23303027
CURRENT_STATUS
02
SITE_LOCATION
340 W GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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_WE5T0?V Analytics Use Only CuMody:Transfer R6cord/Lab`Work Request <br /> WESTGN Anatytics <br /> Relri erato+;0Use Oniy. <br /> ttri c-Containor Samples Were: <br /> Chert Volume 1 Shipped or Hand--�-N <br /> prtivered ' <br /> Work order Preservative _ = NOTES: <br /> Date Recd. Date Due <br /> ANALYSES 2 Ambient or Chilled <br /> RFW Contact ^� <br /> REQUESTED NOTES <br /> Client ContactlPhone ! U <br /> A Usa OnlyMatrix Date 3 Received BrakerV <br /> Lab 10 Client ID]Description Collected <br /> Leaking(Improperly <br /> t <br /> Sealed) <br /> � <br /> 3 NOTES: <br /> r ; 4 PrOperly Preserved <br /> y i N <br /> ` iVOT1=5: <br /> 5 Received With'n <br /> HoOng Times <br /> y N <br /> NOTES. <br /> GOC Tape Was: <br /> 1 Present on Outer <br /> Package Y N <br /> 2 Unbroken on Outer <br /> 1 <br /> T Package Y N <br /> 3 Present on Sample <br /> Y N <br /> 4 Unbroken on Sample <br /> aAetrix: W•Waler DS-Drum Solids %-Other Speciallnstructions, NOTES: y N <br /> S-SoH <br /> 0-011 OL-Drum Liquids <br /> SE.Sediment A-Air F•Flsh <br /> $O Solid Wt-Wipe L• EPITCLP"echata <br /> COC Record Was: <br /> Item1Reason Re1in wished b Received b Date Time }tentlReas�an Relin wished 4 Received 6 Date Time 1 Present Upon Receipt <br /> ,7 of Samples,Y� N <br /> Discrepancies-tetween <br /> Sampla Labels and CDC - <br /> Record? Y , N <br /> NOTES:, <br /> z 7•t15 <br /> RFW 21-21-001/A•I2J88 <br />
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