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ARCHIVED REPORTS_XR0004014
EnvironmentalHealth
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2900 - Site Mitigation Program
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PR0527611
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ARCHIVED REPORTS_XR0004014
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Entry Properties
Last modified
3/4/2020 2:53:58 PM
Creation date
3/4/2020 2:02:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004014
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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4 <br /> Alpha Analytical, Inc <br /> Phone (775)355-1044 FAX (775) 355-0406 <br /> Sample Receipt Checklist <br /> Date Report is due to Client 5114102 Date of Notice 5/6102 8 59 18 AM <br /> Please take note of any Non-Compliant check marks If we receive no response concerning these stems within 24 hours of the date of this <br /> notice, all of the samples will be analyzed as requested <br /> Client Name Stratus Environmental Project ID 2002-1426-011 IBC <br /> Project Manager Jay Johnson Client s Phone (530) 676-6000 Chent s FAX (530) 676-6005 <br /> Work Order Number STR02050620 Date Received 516102 Received by Graciela Navarrete <br /> Chain of Custody COCJ Inform_a_tion <br /> Carrier name FedEx <br /> Cham of custody present? Yes Vi No <br /> Custody seals intact on shippping contamerlcooler? Yes _�J' No Not Present <br /> Custody seals intact on sample bottles? Yes 1-i No Not Present <br /> Chain of custody signed when relinquished and received ? Yes n No <br /> Chain of custody agrees with sample labels? Yes I ' Non-Compliant <br /> Internal Chain of Custody(GOC)requested? Yes _Y_ No <br /> Sub Contract Lab Used None !6 SEM Other(see comments) <br /> Sample Receipt Information <br /> • Shipping contamedcooler in good condition? Yes Ne L J No Not Present L� <br /> Samples in proper container/bottle'; Yes ❑ Non-Compliant <br /> Sample containers intact? Yes No <br /> Sufficient sample volume for indicated test? Yes ! No <br /> Sample Preservat:on and Hold Time(HT) Information <br /> All samples received within holding time? Yes Non-Compliant <br /> Cooler Temperature <br /> Container/Temp Blank temperature in compliance(0-6`C)? Yes Non Compliant 4°C <br /> Water VOA vials have zero headspace? Yes Non-Compliant No VOA vials submit*ed <br /> TOC,Wafer-p'i acceptable upon re^eiot? Yes ❑ ❑ No NIA ; <br /> TOC Samples should have a pH<2(H2SO4) <br /> Analyttcal Requirement Information <br /> Are non-Standard or Modified methods requested ? Yes No <br /> Are there client specific Project requirements? Yes No If YES see the Cham of Custody(COC) <br /> Comments <br /> • <br />
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