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ARCHIVED REPORTS_XR0008045 CASE 1
EnvironmentalHealth
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2900 - Site Mitigation Program
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PR0505512
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ARCHIVED REPORTS_XR0008045 CASE 1
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Last modified
5/28/2020 2:50:57 PM
Creation date
5/28/2020 2:03:14 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008045 CASE 1
RECORD_ID
PR0505512
PE
2950
FACILITY_ID
FA0006827
FACILITY_NAME
BP/MOBIL SERVICE STATION
STREET_NUMBER
2375
Direction
N
STREET_NAME
TRACY
STREET_TYPE
BLVD
City
TRACY
Zip
95376
APN
23207003
CURRENT_STATUS
02
SITE_LOCATION
2375 N TRACY BLVD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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LSauers
Tags
EHD - Public
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SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIENT NAME: DATE Received at Lab: (Driuking water)for <br /> lLEC BY fpm TIME Received at Lab: regulatory purposes. YES/NO <br /> WORKORDER N 3 LOG IN DATE: 7U-40 (Wastewater)for <br /> regulatory purposes, YES/NO <br /> CIRCLE 1111 APPROPRIATE RESPONS LAB SAMPLE DATE <br /> SAMPLE# # CLIENT ID DESCRIPTION MATRIX SAMPLED CONDITION(ETC.) <br /> I Cuslodr Seals) nese 1 W�I tis.► <br /> x <br /> In ct/ en* <br /> 2 Chaut-of-CustodyPresen 1 Absent* <br /> `i Traffic Reports or <br /> Packrn List Present 1bsen <br /> 4 Airblll Airbill l St <br /> Present/ sent <br /> 5 Anbill 4 <br /> 6 Sara le Labels res t f Absent <br /> f <br /> 7 Sample,IDs91t <br /> /Not Listed <br /> ain-of Custod ' <br /> 8 Sample Condttron int ct/Broken*1 <br /> n * <br /> 9 Does information on <br /> clistody reports, traffic — k <br /> reports and sample <br /> labcls a reel Q)sNo* <br /> 10 Sample received Nvitlun <br /> bold time A/No* <br /> J1 Proper Presematrves <br /> used 1 No* <br /> 12 Temp ReL at Lab <br /> F <br /> lAc, {,{.iiIG4 Iange for samples <br /> rc�i u�en► ttic, al pres 411-2°C) Y /.No* <br /> *tf Circled, contact Project Manager and attach record of r tut[ou. <br /> Snip r I Rae aipl Log <br /> Geri-I}r 1 (11110100) of <br />
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