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ARCHIVED REPORTS_XR0006473
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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Y
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YOSEMITE
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1012
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3500 - Local Oversight Program
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PR0545948
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ARCHIVED REPORTS_XR0006473
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Entry Properties
Last modified
9/29/2020 10:24:28 PM
Creation date
8/5/2020 3:51:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006473
RECORD_ID
PR0545948
PE
3528
FACILITY_ID
FA0005159
FACILITY_NAME
FILL-EM FAST
STREET_NUMBER
1012
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
21903024
CURRENT_STATUS
02
SITE_LOCATION
1012 W YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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Ar on Laboratories Sample Receipt Checklist <br /> Client Name �rL pate&Time Received 1 0,26 / 0 3 11 00 <br /> r �1ad8�-R <br /> Project Name R P / Client Project Number l a� a�`• awl d <br /> Received By Su-S a-+`\ Matnx _ __ager Soil 1 ^� <br /> ' Sample Carver Client aboralory _FedEx 1 UPS 1 <br /> Argon Labs Project Number <br /> ' Snipping Container 1 Cooler in good condition? Samples received in proper containers? Yes r/ No <br /> NIA Yes ✓ No Samples received intact? Yes '� No <br /> Samples received under refngerawn?/ Sufficient sample volume for requested tests? / <br /> Yes ✓ No Yes ✓ No <br /> Chain of Custody Present? Yes�z No Samples received within holding time? Yes ✓ No <br /> Chain of Custody signed by all parties Do samples contain proper preservative? <br /> Yes No NIA Yes V/ No <br /> ' Cnain 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 SECTION BELOW <br /> Dale Client Contacted <br /> Person Contacted <br /> ' Contacted by Subject <br /> .omments <br /> Acton Taken <br /> OTHER <br /> Date Client Contacted Person Contacted <br /> Comments <br /> I I <br /> I <br /> I I l r I I I <br /> l I I' I I I <br /> r I I <br /> I I I <br /> I li i <br /> II 'I is I i t Ili ,' rI il' <br />
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