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ARCHIVED REPORTS_XR0002227
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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574
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3500 - Local Oversight Program
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PR0545205
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ARCHIVED REPORTS_XR0002227
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Entry Properties
Last modified
1/27/2020 3:42:20 PM
Creation date
1/27/2020 3:09:24 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002227
RECORD_ID
PR0545205
PE
3528
FACILITY_ID
FA0003164
FACILITY_NAME
NORTH POLE GAS & FOOD INC
STREET_NUMBER
574
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
574 W GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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STL <br /> STL San Francisco <br /> E' <br /> Sample Receipt Checklist <br /> 11pubmission # 2005- 1 <br /> Checklist completed by (initials) =)��l Date r I i� 105 <br /> Courier name TL San Francisco ❑ Client <br /> �/ �' Not <br /> Custody seals intact on shipping container/samples Yes No Present / <br /> Chain of custody present? Yes / No <br /> Chain of custody signed when relinquished and received? Yes-,�No <br /> A <br /> Chain of custody agrees with sample labels? Yes No ► <br /> Samples in proper container/bottle? Yes e/rNo <br /> Sample containers intact' Yes No <br /> Sufficient sample volume for indicated test? Yes �No <br /> All samples received within holding time? Yes No <br /> me +J"°� "!S "i-' "`ro' •+ar.c'? 'q e» x ,.�Q�t erlT ��� r�k t � <br />� el <br /> i;ri. o <br /> $ <br /> arilt?d<4t3� <br /> P <br /> � � 'S# > ��"� �' -�, F- . �=r-� � 'k •P�,'4 3F- �.: � 3`�' g -p��}';6.- '�f'bs.' 7 <br /> 7 <br /> o- <br /> 0a'ter <br /> VOA vials have zero headspace? No VOA vials submitted Yes /� No <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as 5 (small --O) M (medium - O) or L (large-- O) <br /> Water pH acceptable upon receipt? ❑Yes ❑ No <br /> ❑ pH adjusted- Preservative used ❑ HNO3❑ HCI ❑ H2SO4❑ NaOH ❑ZnOAc-Lot#(s) <br /> For any item check-listed "No", provided detail of discrepancy in comment section below <br /> comments- �r Ilk 0 <br /> P <br /> Project Management [Routing for Instruction of Indicated dlscrepancy(ies)] <br /> Project Manager (initials) Date 1 105 <br /> Client contacted ❑ Yes ❑ No <br /> Surninary of discussion <br /> Corrective Achori (per PM/Client) <br />
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