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3500 - Local Oversight Program
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PR0545272
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Last modified
1/31/2020 6:00:03 PM
Creation date
1/31/2020 4:30:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545272
PE
3528
FACILITY_ID
FA0006898
FACILITY_NAME
RAMOS OIL-FRENCH CAMP
STREET_NUMBER
10842
Direction
S
STREET_NAME
HARLAN
STREET_TYPE
RD
City
FRENCH CAMP
Zip
95231
APN
19333028
CURRENT_STATUS
02
SITE_LOCATION
10842 S HARLAN RD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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U <br /> Argon Laboratories Sample Receipt Checklist - <br /> j <br /> Client Name: Lee&Pierce Date&Time Received: 09/19106 14:40 <br /> Project Name: Beneto, Inc 10842 Harlan Roadi Client Project Number: j <br /> Received By: PH Matrix: Water ❑ Soil ❑ Sludge ❑ <br /> Sample Carrier: Client Q Laboratory ❑ Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number: G609043 <br /> Shipper Container in good condition? Samples received in proper containers? Yes No ❑ <br /> N/A_ Yes Q No ❑ Samples received intact? Yes Q No ❑ <br /> Samples received under refrigeration? Yes 0 No ❑ Sufficient sample volume for requested tests?Yes ❑ No ❑ <br /> CChain of custody present? Yes ❑ No ❑ Samples received within holding time? Yes ❑ No ❑ <br /> Chain of Custody signed by all parties? Yes ❑ No , ❑ Do samples contain proper preservative? <br /> E! <br /> N/A ❑ Yes El- No ElE <br /> E <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> t1 Yes ❑✓ No ❑ (None submitted ❑) Yes ❑ No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> L� Date Client Contacted: Person Contacted: <br /> Contacted By: Subject: <br /> Comments: <br /> I <br /> Action Taken: <br /> Ci <br /> 1 <br /> ADDITIONAL TEST(S)REQUEST/OTHER <br /> Contacted By: Date: Time: I <br /> Call Received By: <br /> Comments: <br /> t <br /> i <br /> C � <br /> F <br />
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