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2900 - Site Mitigation Program
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PR0527419
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Last modified
4/7/2020 1:15:01 PM
Creation date
4/7/2020 1:07:27 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0527419
PE
2950
FACILITY_ID
FA0018566
FACILITY_NAME
YARA NO AMERICA / POS
STREET_NUMBER
0
STREET_NAME
REID
STREET_TYPE
AVE
City
STOCKTON
Zip
95203
APN
16203001
CURRENT_STATUS
01
SITE_LOCATION
REID AVE
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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'—� McCamnbell Anah, ical, Inc. 1534N'ignl I'm 10A rm hurt ('n 94565-1701 <br /> • �. N h.w,cn mV 'mph 11 ''m 1 m ut.mniny mccamplwlI om <br /> "X'Im,Ounlim('umns" '1 d,ph,ne.R?r..`-T(_ Fan:925-25'-9'69 <br /> Sample Receipt Checklist <br /> Client Name: WGR Southwest, Inc. Dale and Time Received: 10lW2007 6:56:55 PM <br /> Project Name: #773.PRI.02 Checklist completed and reviewed by: Ana Venegas <br /> WorkOrder N°: 0710131 Matrix Soil Carrier: Michael Hernandez(MAI Courier) <br /> Chain of Custody(COC)Information <br /> Chain of custody present? Yes Q No❑ <br /> Chain of custody signed when relinquished and received? Yes Q No❑ <br /> Chain of custody agrees with sample labels? Yes Q No ❑ <br /> Sample IDs noted by Client on COC? Yes Q No ❑ <br /> Date and Time of collection noted by Client on COC? Yes Q No❑ <br /> Sampler's name noted on COC? Yes Q No❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No ❑ NA <br /> Shipping container/cooler in good condition? Yes Q No ❑ <br /> Samples in proper containers/bottles? Yes Q No ❑ <br /> • Sample containers intact? Yes Q No ❑ <br /> Sufficient sample volume for indicated test? Yes Q No ❑ <br /> Sample Preservation and Hold Time INTI Information <br /> All samples received within holding time? Yes Q No❑ <br /> Container/Temp Blank temperature Cooler Temp: 8.4°C NA ❑ <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑ No❑ No VOA vials submitted <br /> Sample labels checked for correct preservation? Yes Q No❑ <br /> TTLC Metal-pH acceptable upon receipt(pH<2)? Yes ❑ No❑ NA <br /> _____________________________________________ <br /> _____________________________________________ <br /> Client contacted: Date contacted: Contacted by: <br /> Comments: <br /> • <br />
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