My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
ARCHIVED REPORTS_XR0004430
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
M
>
MAIN
>
419
>
3500 - Local Oversight Program
>
PR0545347
>
ARCHIVED REPORTS_XR0004430
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
2/6/2020 4:56:24 PM
Creation date
2/6/2020 3:36:57 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004430
RECORD_ID
PR0545347
PE
3528
FACILITY_ID
FA0003685
FACILITY_NAME
DBA CIRCLEK, REFUEL PETROLEUM INC.
STREET_NUMBER
419
Direction
S
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
21938610
CURRENT_STATUS
02
SITE_LOCATION
419 S MAIN ST
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\wng
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
71
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
' I ........ __.-------- <br /> Amon <br /> Ar on Laboratories Sample Receipt Checklist <br /> • Client Name: ioy 7 r,5stfjl(3r�� Date&Time Received: Q7 <br /> Prajecl Name: 41--3 0YE2-7- A-e 4-ItJ 71 ,' Client Project Number: 3 7� <br /> Received By: -rxz A <br /> Matrix: Water Soil / <br /> Sample Carrier: ClientCLaborato edEx 1 UPS <br /> Argon Labs Project Number: -2-02 / <br /> Shipping Container/Cooler in good co/ndition? Samples received in proper containers? Yes 1/ No <br /> NIA Yes ✓ No Samples received intact? Yes ✓ No <br /> Samples received under refrigeration? Sufficient sample volume for requested tests? <br /> '/No Yes � No <br /> Chain of Custody Present? Yes Yes f No Samples received within holding time? Yes No <br /> Chain of Custody signed by all parties? Do samples contain proper preservative? <br /> Yes /"No NIA Yes Z No <br /> Chain of Custody matches all sample labels? <br /> Do VOA vials contain zero headspace? <br /> Yes Z No (None submitted)Yes✓/ No <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 /> Action Taken: <br /> - - - - . _ - . _ � . - -- - - - - . �, _OTHER Date Client Contacted: Person Contacted: <br /> Comments: <br /> i <br />
The URL can be used to link to this page
Your browser does not support the video tag.