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ARCHIVED REPORTS_XR0012221
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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W
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WILSON
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102
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3500 - Local Oversight Program
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PR0545890
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ARCHIVED REPORTS_XR0012221
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Entry Properties
Last modified
7/22/2020 12:12:06 PM
Creation date
7/22/2020 11:44:06 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012221
RECORD_ID
PR0545890
PE
3526
FACILITY_ID
FA0025958
FACILITY_NAME
ROEK BROTHERS CONSTRUCTION
STREET_NUMBER
102
Direction
S
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
15502065
CURRENT_STATUS
02
SITE_LOCATION
102 S WILSON WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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. . Ar on Laboratories Sample Receipt Checklist <br /> Client Nam ro u V) . . Date&Time Received: t2 2Z I •4� <br /> Protect Name: I \ Client Project Number: <br /> Received By: Matrix: Water LI Soil ❑ Other <br /> Sample Carrier: Client [Laboratory ❑ Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number: <br /> Shipper Container in good condition? Sufficient sample volume for requested tests?Yes E�K No ❑ <br /> NIA [� Yes ❑ No ❑ Samples received within holding time? Yes No ❑ <br /> Samples received under refrigeration? Yes 10No ❑ Do samples contain proper preservative? <br /> NIA ❑ Yes � No ❑ <br /> Chain of custody present? Yes [ No ❑ VOA vials with preservative? <br /> NIA El Yes d No ❑ <br /> Chain of Custody signed by all parties? Yes [ No ElVOA vials preservativ type: <br /> HCL [ Na2S203 ❑ Other <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes No ❑ NIA ❑ Yes Q( No ❑ j <br /> Samples received in proper containers?Yes [� No ❑ s <br /> ❑ Samples received intact? Yes No i <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 Taken: <br /> ADDITIONAL TEST(S)REQUEST I OTHER <br /> Contacted By: Date: Time: <br /> Call Received By: <br /> Ccmments <br /> r <br /> v.5.02 <br />
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