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ARCHIVED REPORTS_XR0009754
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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S
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SECOND
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106
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3500 - Local Oversight Program
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PR0545680
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ARCHIVED REPORTS_XR0009754
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Entry Properties
Last modified
5/20/2020 2:53:14 PM
Creation date
5/20/2020 2:40:19 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0009754
RECORD_ID
PR0545680
PE
3528
FACILITY_ID
FA0005535
FACILITY_NAME
THIEMANS SERVICE
STREET_NUMBER
106
STREET_NAME
SECOND
STREET_TYPE
ST
City
RIPON
Zip
95366
CURRENT_STATUS
02
SITE_LOCATION
106 SECOND ST
P_LOCATION
05
P_DISTRICT
005
QC Status
Approved
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LSauers
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EHD - Public
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Ar on Laboratories Sample Receipt Checklist <br /> • Client Names5c�,1/}Tf:5 Date&Time Received 7— 1 /V / 0-3 <br /> Project Name lLav l Jc �vrcE Client Project Number Sq Zroo 000 1 <br /> Received By Matrix Water Soil 1 <br /> Sample Camer C1 en / Laborator, S 1 <br /> Argon Labs Protect Number _L:�n-1'Z S( <br /> Shipping Container 1 Cooler in good condition? Samples received in proper containers? Yes `� No <br /> N/A ✓Yes Na Samples received intact? Yes No <br /> Samples received under refrigeration? Sufficient sample volume for requested tests? ✓ <br /> Yes f No Yes No <br /> Chain of Custody Present? Yes `� No Samples received within holding time) Yes ✓ No <br /> Chain of Custody signed by all paTtes? Do samples contain proper preservative? <br /> Yes ✓ No NIA Yes--"" No <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? / <br /> Yes '� No (None submitted )Yes ✓ No <br /> ANY"No" RESPONSE MUST BE DETAILED IN THE COMMENTS SECT10N-BELOW- <br /> Date Client Contacted Person Contacted <br /> Contacted by Subject <br /> Comments <br /> Action Taken <br /> OTHER <br /> Date Client Contacted Person Contacted <br /> Comments <br />
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