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ARCHIVED REPORTS_XR0004008
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0527611
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ARCHIVED REPORTS_XR0004008
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Last modified
3/4/2020 3:13:46 PM
Creation date
3/4/2020 1:47:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004008
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
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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 811912003 Date of Notice 8/11/2003 11 00 22 <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 ISC Stockton <br /> Project Manager Gown Kowtha Client's Phone (530) 676-6002 Clients FAX (530)676-6005 <br /> Work Order Number STR030811" Date Received 819/2003 Received by Dolly S Baker <br /> Chain of Custody GOC Information <br /> Carrier name FedEx <br /> Chain of custody present? Yes No <br /> Custody seals intact on shippp:ng container/cooler? Yes ✓1 I No Not Presen <br /> Custody seals intact on sample bottles? Yes No Not Presen ill <br /> Chain of custody signed when relinquished and received? Yes No <br /> Chain of custody agrees with sample labels? Yes ❑ FYI No <br /> Internal Chain of Custody(COC)requested? Yes ❑ F�j No <br /> Sub Contract Lab Used None 11/1 ❑ SEM Other(see comments) ❑ <br /> Sample Receipt Information <br /> hipping container/cooler in good condition? Yes ❑ No Not Presen <br /> Samples in proper container/bottle? Yes 116 F1 No <br /> Sample containers intact? Yes `/ ❑ No <br /> Sufficient sample volume for indicated test? Yes ✓ ❑ No <br /> Sample Preservation and Hold Time(HT)Information <br /> Ali samples received within holding time? Yes .� No Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6°C)? Yes vf] No 40C <br /> Water-VOA vials have zero headspace 1 no bubbles? Yes No No VOA vials submitted E_ I <br /> TOC Water-pH acceptable upon receipt? Yes I No NIA i✓I <br /> TOC Samples should have a pH<2(H2SO4) <br /> Analytical Requirement Information <br /> Are non-Standard or Modified methods requested? Yes F-7NO <br /> Are there client specific Project requirements? Yes 171 ✓J No If YES see the Chain of Custody(COC) <br /> Comments Sample VOA amounts listed on COC do not match VOA's received noted on original COC by Alpha-Sac <br />
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