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ARCHIVED REPORTS_XR0002845
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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3555
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3500 - Local Oversight Program
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PR0545252
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ARCHIVED REPORTS_XR0002845
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Entry Properties
Last modified
1/31/2020 3:10:27 PM
Creation date
1/31/2020 11:41:19 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002845
RECORD_ID
PR0545252
PE
3528
FACILITY_ID
FA0002232
FACILITY_NAME
QUIK STOP MARKET #3132*
STREET_NUMBER
3555
Direction
W
STREET_NAME
HAMMER
STREET_TYPE
LN
City
STOCKTON
Zip
95209
APN
071-180-20
CURRENT_STATUS
02
SITE_LOCATION
3555 W HAMMER LN
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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16 so= <br /> ISample Raceipt Checklist STL San Francisco <br /> Submission #: 2002- <br /> ' Checklist completed by: (initials)6Q—Date: --�.�F-1 (jl_�102 <br /> Courier name: ❑ S L San Francisco ❑ Client <br /> Not <br /> Custody seals intact on shipping contain erisam pies Yes No Present <br /> Chain of custody present? Yes No <br /> I <br /> Chain of custody signed when relinquished and received? Yes ✓ No <br /> Chain of custody agrees with sample labels? Yes ✓ No <br /> Samples in proper containedbottle? Yes -✓No <br /> Sample containers intact? Yes__&ZNo <br /> Sufficient sample volume for indicated test? Yes `/Nc <br /> All samples received within holding time? / Yes L.�No <br /> Container/Temp Blank temperature in compliance(40 C±2)? Temp: �r °C Yes `� No <br /> ater-VOA vials have zero headspace? No VOA vials submitted Yes_ZNo <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as S(small -O), M (medium - O)or L(large- V) <br /> Water-pH acceptable upon receipt? ❑Yes ❑ No <br /> ' ❑ pH adjusted- Preservative used: ❑ HNO3❑ HCI ❑ H2SO4 ❑ NaOH ❑2nOAc <br /> For an item check-listed "No" provided detail of discrepancy in comment section below: <br /> y � <br /> Comments: <br /> I <br /> Project Management [Routing for instruction of indicated discrepancy(ies)] <br /> Project Manager: (initials) Date: 1 IO2 <br /> Client contacted: ❑ Yes ❑ No <br /> ISummary of discussion: <br /> 1 <br /> orrective Action (per PWClient): <br />
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