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ARCHIVED REPORTS_XR0002365
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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3500 - Local Oversight Program
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PR0545195
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ARCHIVED REPORTS_XR0002365
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Entry Properties
Last modified
1/23/2020 3:17:54 PM
Creation date
1/23/2020 2:48:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002365
RECORD_ID
PR0545195
PE
3528
FACILITY_ID
FA0002915
FACILITY_NAME
TRACY MARKET INC
STREET_NUMBER
15
Direction
E
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
21435004
CURRENT_STATUS
02
SITE_LOCATION
15 E GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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• Argon Laboratories Sample Receipt Checklist <br /> eFt Name 7 �c,rr>—, tnc Cats&Time Receiveo "7 f C(, 1 <br /> C=�?n•name t--' ✓v C7 �3 fi Clieni Rroisct Number 54 <br /> ;eceiv`-0 Ev Mainx water Sad ❑ Clher <br /> -aneie rarr,es Ct,ent ❑ Laboratory '� Fea Ex !} UPS ❑ Other <br /> 7 <br /> -19c'3_abs P'olect Number il� <br /> .-ri Poe,Container in good condition3 Sutfic ent sample vdurne for requested tests? res t ' No <br /> r , <br /> f1A ❑ les No ❑ Samples received within holding lime? `les No ❑ <br /> Samoies received under refngerauon? Yes No ❑ Do samples contain proper preservative? <br /> N/A ❑ Yes No <br /> Chain of custody present? Yes No ❑ VOA vials with preservative? <br /> N/A ❑ Yes � No <br /> Cr,arn of Custody signed by all partes? Yes41 No ❑ VOA vials preservative type <br /> HCL Na2S203 ❑ Otr,er <br /> rain of Costody matches all sample labels? Go VOA vials contain zero headsoace? <br /> �es No ❑ WA ❑ Yes No <br /> 5ar',D+es ecewed in proper coma vers? Yes No ❑ Samples received intact? Yes No <br /> ANY"No" RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Dale Client Contacted Person Contacted <br /> Contacted By Subject <br /> Comments <br /> 40on Taken <br /> ADDITIONAL TEST(S)REQUEST I OTHER <br /> Contacted By pate Time <br /> Call Pece-ved By <br /> Cvrnment5 <br /> X502 <br />
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