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COMPLIANCE INFO
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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WASHINGTON
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2900 - Site Mitigation Program
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PR0545445
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COMPLIANCE INFO
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Entry Properties
Last modified
3/3/2020 4:40:31 PM
Creation date
3/3/2020 4:20:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0545445
PE
2961
FACILITY_ID
FA0025798
FACILITY_NAME
CALIFORNIA ARMY NATIONAL GUARD
STREET_NUMBER
333
Direction
N
STREET_NAME
WASHINGTON
STREET_TYPE
ST
City
LODI
Zip
95240
APN
04123045
CURRENT_STATUS
02
SITE_LOCATION
333 N WASHINGTON ST
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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Page 10 of 87 <br /> WORK ORDER #: O-OZ- 19 D 510] <br /> XV 1;� -- -, .. <br /> Cooler k of <br /> CLIENT: CST DATE: 02 /C)Z-/ 10 <br /> TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0"C—6.0°C, not frozen) �� <br /> Temperature Z- . f7 °C + 0.5 OC (CF) = 2 . 5-°C ElBlank 21 Sample <br /> ❑ Sample(s) outside temperature criteria (PM/APM contacted by: ). <br /> ❑ Sample(s)outside temperature criteria but received on ice/chilled on same day of sampling. <br /> ❑ Received at ambient temperature, placed on ice for transport by Courier. <br /> Ambient Temperature: ❑ Air ❑ Filter ❑ Metals Only ❑ PCBs Only Initial: wb <br /> CUSTODY SEALS INTACT: <br /> ❑ Cooler ❑ ❑ No (Not Intact) 2-Mot Present ❑ N/A Initial: V,-V-�2 <br /> ❑ Sample ❑ ❑ No (Not Intact) Z7Not Present Initial: <br /> SAMPLE CONDITION: Yes No N/A <br /> Chain-Of-Custody (COC) document(s) received with samples................... C' ❑ ❑ <br /> COC document(s) received complete................................................... ❑ ❑ <br /> ❑ Collection date/time, matrix, and/or#of containers logged in based on sample labels. <br /> ❑ No analysis requested. ❑ Not relinquished. ❑ No date/time relinquished. / <br /> Sampler's name indicated on COC..................................................... El El h2' <br /> Sample container label(s) consistent with COC.....................................• 2"- ❑ ❑ <br /> Sample container(s) intact and good condition...................................... V ❑ ❑ <br /> Proper containers and sufficient volume for analyses requested............... R/ El <br /> Analyses received within holding time................................................. L'/ ❑ ❑ <br /> Proper preservation noted on COC or sample container.......................... ❑ ❑ <br /> ❑ Unpreserved vials received for Volatiles analysis <br /> Volatile analysis container(s)free of headspace..................................... ❑ ❑ <br /> Tedlar bag(s)free of condensation...................................................... ❑ ❑ <br /> CONTAINER TYPE: <br /> �y�ro <br /> Solid: 24"ozCGJ ❑8ozCGJ ❑16ozCGJeve ( ) ❑EnCoreso ❑TerraCoreso ❑ <br /> Water: ❑VOA ❑VOAh 0VOAna2 ❑125AGB 0125AGBh ❑125AGBp ❑1AGB 01AGBna2 ❑1AGBs <br /> 0500AGB ❑500AGJ ❑500AGJs ❑250AGB ❑250CGB ❑250CGBs ❑1PB ❑500PB 0500PBna <br /> ❑250PB ❑250PBn 0125PB 0125PBznna 0100PJ ❑100PJna2 ❑ ❑ ❑ <br /> Air: ❑Tedlaro ❑Summa° Other: ❑ Trip Blank Lot#: Checked by: <br /> Container: C:Clear A:Amber P:Plastic G:Glass J:Jar B:Bottle Z:Ziploc/Resealable Bag E: Envelope Reviewed by: <br /> Preservative: h:HCL n:HNO3 na2:Na2S203 Na:NaOH p:H3PO4 s:H2SO4 znna:ZnAc2+NaOH f:Field-filtered Scanned by:&—. <br /> SOP T100_090(07116/09) <br /> 1 , 218 of 295 <br />
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