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ARCHIVED REPORTS_XR0007985
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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W
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WEST
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3302
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3500 - Local Oversight Program
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PR0545872
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ARCHIVED REPORTS_XR0007985
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Entry Properties
Last modified
7/21/2020 4:14:07 PM
Creation date
7/21/2020 4:09:05 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007985
RECORD_ID
PR0545872
PE
3528
FACILITY_ID
FA0025947
FACILITY_NAME
JAYS MINI MART
STREET_NUMBER
3302
Direction
N
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95204
APN
11705037
CURRENT_STATUS
02
SITE_LOCATION
3302 N WEST LN
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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LSauers
Tags
EHD - Public
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' Amon Laboratories Sam ie Recei t Checklist <br /> Client Name -t- <br /> ❑ate&Time Receivedo� / t <br /> nroci tfa,"'2 <br /> Cllen[•Prolect Number <br /> Received By t�� <br /> Matrix Water Rr Soil ❑ Other <br /> Sampfe Carrier Client ❑ Laboratory ] Fed Ex ❑ i9PS ❑ Other ❑ <br /> Argon Labs Project Number piSS <br /> Shipper Container in good condition? Sufficient sample volume for requested tests Yes _ <br /> NIA Yes No❑ � No F7❑ Samples received within holding time? Yes 1�\ No ❑ <br /> Samples received under refrigeraton? Yes No ❑ Do samples contain proper preservative? <br /> NIA LJ Yes No ❑ <br /> Chain of custody present? Yes No <br /> _-❑_ -- VOA vials withr@servattvev - <br /> VJA � Yes No I� <br /> Chain of Custody signed by all partes? Yes No ❑ VOA vials preservative type <br /> MCL � Na2S203 [1 nther <br /> Chain of Custody matches all sample labels <br /> Do VOA vials contain zero headspace? <br /> Yes No E] 00 <br /> ❑ Yes L;�t_ No ❑ <br /> Samosas received in proper containers? Yes �4 No <br /> ❑ Samples received intact? Yes No ❑ <br /> - -- ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted Person Contacted <br /> Contacted By Subject <br /> comments <br /> Action faKen <br /> AUDITIONAL TEST($)REQUEST!OTHER <br /> 4ontacted By Date <br /> Time <br /> Call Received By <br /> comments <br /> v502 <br />
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