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ARCHIVED REPORTS_XR0006724
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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6230
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2900 - Site Mitigation Program
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PR0543479
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ARCHIVED REPORTS_XR0006724
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Entry Properties
Last modified
5/5/2020 10:33:26 AM
Creation date
5/5/2020 9:46:58 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006724
RECORD_ID
PR0543479
PE
2960
FACILITY_ID
FA0024679
FACILITY_NAME
CANEPA'S CAR WASH
STREET_NUMBER
6230
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95204
APN
081360030
CURRENT_STATUS
01
SITE_LOCATION
6230 PACIFIC AVE
P_LOCATION
01
QC Status
Approved
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EHD - Public
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OZ Environmental Doc 11) F3REC005 002 <br /> Revision Date IO/J1/02 page 1 of I <br /> Stockton - Condltiol« Upon Receipt (Attach to COQ) r <br /> Sample Receipt at STK <br /> 1 Number of ice chests/packages received I <br /> 2 Were samples received in a chilled condition? Temps /`5 -L? 6o <br /> Acceptable is above freezing to 5° C Also acceptable is received on )ce (ROI) for the same day of sampling or <br /> received at room temperature (RRT) if sampled within one hour of receipt Client contact for temperature failuzes <br /> must be documented below If many packages are received at one time check for tests/H T 's/rushes/Eact i's to <br /> prioritize further review Please notify Microbiology personnel imrnediately of bacti samples received <br /> 3 Do the number of bottles zeceived agree with the COC? Yes No N/A <br /> 4 Were samples received intact9 (i e no broken bottles, leaks etc } Na <br /> 5 Were sample custody seals ifitact? Yes No <br /> Sign and date the COC, place in a ziplock and put in the same ice chest as & ples <br /> Sample Receipt Review completed by (initials) <br /> Sample Receipt at SP <br /> Were samples received in a chilled condition? Temps <br /> 40 Acceptable is above freezing to 6' C If many pac et&onrar received diately of bacti chcclk for to dT'slrushesBacti s to <br /> pi soritar further review Please notify Microbialogy p <br /> 2 Do the number of bottles received agree with the COC? es No N/A <br /> 3 Were samples received intact? (i e no brokers bottles, leaks etc ) No <br /> 4 Were sample custody seam intact? <br /> N/A Yes No <br /> Sign and date the COC; obtain LEVIS sample numbers, select methods/tests and pnnt labels <br /> cation Labeling and Distribution <br /> Sample V�rifi g <br /> 1 Were all requested analyses understood and acceptable` Yes No <br /> 2 Did battle labels correspond with the client's BYS? s No <br /> 3 Were all bottles requiring sample preservation properly preserved? es No N/A FGL <br /> 4 Were all analyses within holding times at time of recelpt? es No <br /> 5 Have rush or project due dates been checked and accepted` NIA Yes No <br /> Attach labels to the containers and include a copy of the COC for lab deli <br /> Sample Receipt, Login and Verification completed by (initials) <br /> Disci epancy Dociimentation <br /> y items above which are "No" OT 00 riot pike[ S�}eG1f10at`^T c (' tPmncl mi�ct ha rPcnlvarl <br /> rerso;`i Cont�c�ed ` <br /> li�ltiated r Condor r rth TechnoIOGles <br /> r <br /> 1 iQ}J�OtC1 <br /> S" TK@438223 <br /> SPP--11/23/2004 -13 50 28 <br /> r �->n1ut� Ili <br />
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