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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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JAHANT
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6787
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3000 – Underground Injection Control Program
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PR0518315
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Last modified
2/5/2020 5:32:03 PM
Creation date
2/5/2020 4:20:19 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3000 – Underground Injection Control Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0518315
PE
3030
FACILITY_ID
FA0013829
FACILITY_NAME
KOOYMAN DAIRY/ LAB CLEAN UP
STREET_NUMBER
6787
Direction
E
STREET_NAME
JAHANT
STREET_TYPE
RD
City
ACAMPO
Zip
95220
CURRENT_STATUS
02
SITE_LOCATION
6787 E JAHANT RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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Amon Laboratories..Sample Receipt Checklist <br /> Client Name: 2` Date&Time Received: 1 1 I D 2 <br /> Project Name: �� Client Project Number: 47"'1 <br /> Received By: 2:)U-4 a-.v-- Matrix: ati I <br /> Sample Carrier: Client I t Drat ! FedEx I UPS I <br /> Argon tabs Project Number: C O� l D <br /> Shipping Container 1 Cooler in good condition? Yes No NIA <br /> Samples received under refrigeration? Yes ✓ No <br /> Chain of Custody Present? Yes u No <br /> Chain of Custody signed by all parties? Yes ✓ No <br /> Chain of Custody matches all sample labels? Yes--t,/ Na <br /> Samples received in proper containers? Yes / No <br /> Samples received intact? Yes No <br /> Sufficient sample volume for requested tests? Yes--L/ No <br /> Samples received within holding time? Yes--V/ No <br /> Do samples contain proper preservative? Yes ✓ No NIA <br /> F Do VOA vials contain zero headspace? Yes �,/ No (None submitted ) <br /> ANY "No" RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted: Person Contacted: <br /> Contacted by: Subject: <br /> Comments: <br /> I <br /> Action Taken: <br /> 1 <br /> i <br /> i <br /> j . <br />
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