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ARCHIVED REPORTS_XR0002989
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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H
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HAMMER
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1612
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3500 - Local Oversight Program
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PR0545246
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ARCHIVED REPORTS_XR0002989
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Entry Properties
Last modified
1/30/2020 8:20:52 PM
Creation date
1/30/2020 3:11:52 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002989
RECORD_ID
PR0545246
PE
3528
FACILITY_ID
FA0003611
FACILITY_NAME
PARKWOODS GAS & FOOD
STREET_NUMBER
1612
Direction
W
STREET_NAME
HAMMER
STREET_TYPE
LN
City
STOCKTON
Zip
95209
APN
07728002
CURRENT_STATUS
02
SITE_LOCATION
1612 W HAMMER LN
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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_ <br /> STL <br /> STL San Francisco <br /> Sample Receipt Checklist <br /> Submission ##:2004- � _ C <br /> j <br /> Checklist completed by. (initials) kl$�L date: 05 I _�_IO4 <br /> Courier name, 0 STL Sarr F adb-.L3 Client <br /> Custody seals intact a shipping conjAiderlsomples i Y; s. Na- NPreser�t" <br /> Chain of custody present? ,Cesr:No <br /> Chaln of custody signed when relinquished-and received? Yes No <br /> Chain of custody agrees v+r`O sample labels? � Yes ;c/ Nisi <br /> Samples in proper containerlbottie? <br /> Sample containers Intact? i Yes .Nc; <br /> Sufficient sample volume for indicaled test? <br /> All samples received within holding time? i Yes: 1."No: . <br /> ContainerfTemp Blank temperature in compliance (40 C "�2)? Tomis'OM1~°C yes�No <br /> Ite•Phoerrt Yes. <br /> Water-VOA vials have"zero headspace? No VOA vials submitted Yes No <br /> t ---� <br /> i <br /> ' (if bubble is present, refer to approximate bubble size and-it>rmize in commerits )pr L(r ig . . } <br /> l <br /> ( a <br /> tAleEer-pH acceptable upon receipt? D Yes D No <br /> 0 pH adjusted— Preservative used; D HNO3 ❑ HCl Q H2SO4 Q N;ROH 0 ZnOAc--Lot#i(s) ! -- <br /> For any item check-listed "No", provided detail of discrepancy in.cor3nmbrit section�below.i <br /> Comments: �. <br /> Project Management [Routing for instruction 'Of indicated discrepan iy,(ksfl <br /> Project Manager: (initials) gale: 1 104 <br /> Client contacted, © Yes © No <br /> i <br /> Summary of discussion: <br /> l <br /> K <br /> f <br /> Cweetive Action(per PlAfGllent): <br /> i <br /> • j <br />
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