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COMPLIANCE INFO_PRE 2019
EnvironmentalHealth
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2200 - Hazardous Waste Program
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PR0220093
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COMPLIANCE INFO_PRE 2019
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Last modified
5/1/2020 10:17:08 AM
Creation date
5/1/2020 8:21:15 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0220093
PE
2228
FACILITY_ID
FA0002387
FACILITY_NAME
KEYSTONE AUTOMOTIVE INDUSTRIES INC
STREET_NUMBER
632
Direction
S
STREET_NAME
EL DORADO
STREET_TYPE
ST
City
STOCKTON
Zip
95203
APN
14907033
CURRENT_STATUS
02
SITE_LOCATION
632 S EL DORADO ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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I III <br /> WESTON Ar .-s Use Only <br /> Custody Transfer Re.,ird/Lab Work Request <br /> t Page _ of_--,-- <br /> Client 1 '777'7r71 '!-�7' t, /, Refrigerator# <br /> Est. Final Proj. Sampling.Da a #/Type Container Li uid i, <br /> Solid <br /> Work Order# ' } <br /> Volume LI Uld i <br /> Project Contact/Phone# —_ __ Solid <br /> AD Project Manager Preservatives I i,. , t <br /> OC Del TAT ORGANIC INORG <br /> ANALYSES _� Q Q <br /> Date Rec'd Date Due REQUESTED a <br /> Account# >O m a-a- z 2 �U <br /> c <br /> MATRIX - - - <br /> - -CODES-- Matrix <br /> Lab <br /> S- Soil - - <br /> Ip <br /> Client ID/Description QC Matrix Date <br /> SE- Sediment Chosen Collected <br /> SO-Solid <br /> SL- Sludge <br /> W- Water <br /> O- Oil <br /> A- Air <br /> DS-Drum <br /> Solids <br /> DL- Drum <br /> Liquids <br /> L- EP/TCLP <br /> Leachate <br /> WI- Wipe <br /> X- Other <br /> F- Fish <br /> Special Instructions: DATE/REVISIONS: WESTON Analytics Use Only <br /> 1. <br /> Samples were: COC Tape was: <br /> 2• 1)Shipped or 1) Present on Outer_ <br /> 3 =Hand Delivered ` - Package Y or (N <br /> 4. Airbill# 2)Unbroken on Outer <br /> 2)Ambient or Chilled Package Y or N <br /> 5' 3)Received in Good 3) Present on Sample <br /> 6. Condition Y or N Y or; N - <br /> 4)Properly Preserved 4)Unbroken on <br /> Relinquished Received Date Time Relinquished Received Date Time Discrepancies Between Y or N Sample Y or N <br /> by, by by by Samples Labels and <br /> COC Record? Y or N 5)Received Within COC Record Present <br /> 1' <br />
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