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ARCHIVED REPORTS_XR0004004
EnvironmentalHealth
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2900 - Site Mitigation Program
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PR0527611
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ARCHIVED REPORTS_XR0004004
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Last modified
3/4/2020 3:17:35 PM
Creation date
3/4/2020 1:46:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004004
RECORD_ID
PR0527611
PE
2957
FACILITY_ID
FA0018709
FACILITY_NAME
FORMER DOLLY MADISON
STREET_NUMBER
1426
Direction
S
STREET_NAME
LINCOLN
STREET_TYPE
ST
City
STOCKTON
Zip
95206
APN
16503010
CURRENT_STATUS
01
SITE_LOCATION
1426 S LINCOLN ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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1 <br /> Alpha Analytical, Inc. <br /> Phone (775)355-1044 FAX (775)355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client 5/2512004 Date of Notice 5/17/2004 10 00 14 <br /> Please take note of any NO check marks If we receive no response concerning these items within 24 hours of the date of this notice,all of <br /> the samples will be analyzed as requested <br /> Client Name Stratus Environmental Project ID IBC Stockton <br /> Project Manager Gown Kowtha Chent's Phone (530)676-6002 Client's FAX (530)676-6005 <br /> Work Order Number STR04051744 Date Received 5/15/2004 Received by Dolly S Baker <br /> Chain of Custody(COC)Information <br /> Carrier name FedEx <br /> Chain of custody present? Yes n [] No <br /> Custody seals intact on shippping container/cooler? Yes No Not Present ❑ <br /> Custody seals intact on sample bottles? Yes ❑ ❑ No Not Present <br /> Chain of custody signed when relinquished and received? Yes LL ❑ No <br /> Chain of custody agrees with sample labels ? Yes V ❑ No <br /> Sample ID noted by Client on COC? Yes I] ❑ No <br /> Date and time of collection noted by Client on COC? Yes W ❑ No <br /> Samplers s name noted on COC ? Yes ❑ No <br /> 0ternal Chain of Custody(COC)requested? Yes ❑ FVI No <br /> Sub Contract Lab Used None R ❑ SEM Other(see comments) <br /> Sample Recei t Information <br /> Shipping container/cooler in good condition? Yes �` ❑ No Not Present <br /> Samples in proper container/bottle? Yes l`yJ ❑ No <br /> Sample containers intact? Yes [.-/] ❑ No <br /> Sufficient sample volume for indicated test? Yes OW ❑ No I <br /> Sample Preservation and Hold Time (HT)Information <br /> All samples received within holding time? Yes n ❑ No <br /> _ Cooler Temperature <br /> ContainerlTemp Blank temperature in compliance(0-6°C)? Yes W1 ❑ No 4°C <br /> Water-VOA vials have zero headspace/no bubbles? Yes "V] ❑ No No VOA vials submitted ❑ <br /> Sample labels checked for correct preservation? Yes 1v1i ❑ No <br /> TOC Water-pH acceptable upon receipt(H2SO4 pH<2)? Yes ❑ LJ No NIA n <br /> Analical Require nent Information <br /> Are non-Standard or Modified methods requested? Yes ❑ y'] No <br /> Are there client specific Project requirements? Yes ❑ t7 No If YES see the Chain of Custody(GOC) <br /> Comments Samples received 05/15/04 samples kept cold&secure until log-in 05/17/04 <br />
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