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ARCHIVED REPORTS_XR0008565
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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WATERLOO
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2537
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3500 - Local Oversight Program
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PR0545857
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ARCHIVED REPORTS_XR0008565
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Last modified
7/15/2020 9:15:09 PM
Creation date
7/15/2020 2:58:57 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008565
RECORD_ID
PR0545857
PE
3528
FACILITY_ID
FA0005147
FACILITY_NAME
E-Z FOOD
STREET_NUMBER
2537
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
11914035
CURRENT_STATUS
02
SITE_LOCATION
2537 WATERLOO RD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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Argon Laboratories Sample Recei t Checklist <br /> Client Name A I C 45" -&J4,- Date&Time Received 1 1 / 3 0 O <br />' 9!(-M 3 f- 7—sr,Ve s# /00866 <br /> Project Name �G k fen i Client Project Number S`�• Z$K O7 Z 1 <br /> Received By <br /> Matrix ater Soil 1 <br /> Sample Camer Client / bora#o ! FedEx 1 UPS 1 <br /> Argon Labs Project Number PO3,0 <br /> Shipping Container/Cooler in good condition? Samples received i <br /> p n proper containers? Yes No <br /> NIA _Yes No Samples received intact? Yes--,Y— No <br /> Samples received under refrigeration? Sufficient sample volume for requested tests? <br /> Yes No Yeses No <br /> Cham of Custody Present? Yes No Samples received within holding bme? Yes4— No <br /> Chain of Custody signed by all parties? Do samples contain proper preservative? <br />' Yes—X-- No <br /> NIA Yes Na <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> 7k— <br /> Yes 4— No (None submitted Yeses No <br /> 1 <br /> ANY"No" RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted - � <br /> Person Contacted <br />' Contacted by Subject <br /> Comments <br /> i <br /> Action Taken <br /> 1 <br /> OTHER <br /> Date Client Contacted Person Contacted <br /> Comments <br />
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