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FIELD DOCUMENTS
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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LORRAINE
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8004
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2900 - Site Mitigation Program
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PR0528703
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Last modified
3/4/2020 2:32:21 PM
Creation date
3/4/2020 2:29:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0528703
PE
2953
FACILITY_ID
FA0019271
FACILITY_NAME
PG&E LORRAINE AVE TRANSFORMER
STREET_NUMBER
8004
STREET_NAME
LORRAINE
STREET_TYPE
AVE
City
STOCKTON
Zip
95210
APN
09058006
CURRENT_STATUS
01
SITE_LOCATION
8004 LORRAINE AVE
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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Page 10 of 10 <br /> AWO WORK ORDER #: 0 8-ED D-© Q © 0 <br /> fl[fhlS�II���Ilf <br /> ` - Cooler! of <br /> y CLIENT: B Iz CA p3' DATE: I l / 21 / 09- <br /> TEMPERATURE: <br /> O9- <br /> TEMPERATURE: (criteria: 0.00C-6.00C, notfrozen) <br /> Temperature . G oC - 0.2°C (CF) =3. h OC flank ❑ 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 /> V <br /> Ambient Temperature: ❑ Air ❑ Filter ❑ Metals Only ❑ PCBs Only Initial: <br /> CUSTODY SEALS INTACT: <br /> ❑ Cooler ❑ ❑ No(Not Intact) blot Present ❑ N/A Initial: liv <br /> ❑ Sample ❑ ❑ No (Not Intact) C3'lTo-t Present Initial: <br /> SAMPLE CONDITION: <br /> �. Yes No N/A <br /> Chain-Of-Custody document(s) received with samples................. a' ❑ ❑ <br /> Sampler's name indicated on COC..-. ...................................... ❑ ❑ <br /> Sample container label(s)consistent with COC........................... 23-� ❑ ❑ <br /> Sample container(s) intact and good condition............................ lz� ❑ ❑ <br /> Correct containers and volume for analyses requested................. 0� ❑ ❑ <br /> Analyses received within holding time...................................... [Y ❑ ❑ <br /> L <br /> Proper preservation noted on sample label(s)............................. ❑ ❑ O� <br /> Volatile analysis container(s)free of headspace.......................... ❑ ❑ ff� <br /> Tedlar bag(s)free of condensation........................... <br /> CONTAINER TYPE: � . <br /> Solid: 04ozCGJ ❑8ozCGJ ❑16ozCGJ {?!Sleeve ❑EnCOreSO ❑TerraCOreSO ❑ <br /> Water: ❑VOA ❑VOAh ❑VOAna2 0125AGB 0125AGBh 0125AGBpo4 01AGB 01AGBna2 <br /> V <br /> 01AGBs ❑500AGB ❑500AGBs ❑250CGB 0250CGBs 111PB ❑500PB ❑500PBna ❑250PB <br /> 11250PBn ❑125PB ❑125PBznna 0100PBsterile ❑100PBna2 ❑ ❑ ❑ <br /> t. Air: ❑TedlaTO ❑Summa® ❑ Checked/Labeled by: <br /> Container: C:Clear A:Amber P:PolylPlastic G:Glass J:Jar B:Bottle Reviewed by: <br /> Preservative: h:HCL n:HNO3 na2:NazS203 na:NaOH po,:H,PO, s:H2SO4 znna:ZnAc,+NaOH Scanned by: <br /> V <br /> SOP T100_090(11106/06) <br /> V <br /> F� <br />
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