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EnvironmentalHealth
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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 /> C <br /> Argon Laboratories Sample Receipt Checklist <br /> CI Client Name: Lee&Pierce Date&Time Received: 10/31/06 10:00 <br /> Project Name: Beneto, Inc. 10842 Harlan Road Client Project Number: ` <br /> Received By: RS Matrix: Water ❑ Soil ❑ Sludge ❑ f <br /> Sample Carrier: Client ❑ Laboratory 2 Fed Ex ❑ UPS ❑ Other ❑ <br /> CArgon Labs Project Number: G610051 <br /> Shipper Container in good condition? Samples received in proper containers? Yes No ❑ '� <br /> N/A` Yes No ❑ Samples received intact? Yes ❑. No ❑ <br /> �± Samples received under refrigeration? Yes Q No ❑ Sufficient sample volume for requested tests?Yes 0 No ❑ f <br /> 1 Chain of custody present? - Yes ❑ No ❑ Samples received within holding time? Yes ED No ❑ ` <br /> Ir Chain of Custody signed by all parties? Yes ED No ❑ Do samples contain proper preservative? <br /> N/A ❑ Yes 0 No ❑ <br /> L' Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes No ❑ (None submitted ❑) Yes ❑ No ❑ <br /> ISL+: ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> ------=--------------------------------- <br /> �j Date Client Contacted: Person Contacted: <br /> Contacted By: Subject: <br /> Comments: <br /> L <br /> Action Taken. <br /> L' <br /> a <br /> . .ADDITIONAL TEST($)REQUEST I OTHER <br /> LL Contacted By: Date: Time: <br /> Call Received By: <br /> Comments: <br /> if *16 ♦ f <br /> L� <br />
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