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ARCHIVED REPORTS_XR0006642
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_XR0006642
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Entry Properties
Last modified
9/29/2020 10:21:33 PM
Creation date
8/5/2020 4:10:20 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006642
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
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LSauers
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EHD - Public
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SPL HOUSTON ENVIRONMENTAL LABORATORY <br /> SAMPLE LOGIN CHECKLIST <br /> DATE: � [ <br /> TIME: CLIENT NO. <br /> WLOT NO. CONTRACT NO. <br /> CLIENT SAMPLE NOS. <br /> SPL SAMPLE NOS. : + �T <br /> YES NQ <br /> 1. Is a Chain-of-Custody form present? <br /> 2. Is the COC properly completed? <br /> If no, describe what is incomplete: <br /> If no, has the client been contacted about it? <br /> (Attach subsequent documentation from client about the situation) <br /> 3. Is airbxll/packin � / ill of lading with shipment? �C <br /> If yes, ID#:_ TT <br /> W. Is a USEPA Traffic Report present? <br /> . Is a USEPA SAS Packing List present? / <br /> b. Are custody seals present on the package? T <br /> If yes, were they intact upon receipt? <br /> 7. Are all samples tagged or labeled? <br /> Do the sample tags/labels match the COC? <br /> If no, has the client been contacted about it? <br /> (Attach subsequent documentation from client about the situation) <br /> 8. Do all shipping documents agree? <br /> If no, describe what is in nonconformity: <br /> I <br /> 9. Condition/temperature of shipping, container: <br /> 18. Condition/temperature of sample bottles: <br /> 11. Sample Disposal? : r SPL ldisposa Yr ReturrPto client <br /> NOTES (reference item number if applicable) : <br /> I <br /> ATTEST: ! ' DATE: <br /> I <br /> WESOLVED:' <br /> ELIVERED FOR �RESOLUTIO : RECD DATE: <br /> DELIVERED <br /> I J l !' ' I ' it DATE:( <br /> IEI ! ! <br /> V! <br /> h ! <br />
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