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ARCHIVED REPORTS_XR0012858
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_XR0012858
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Entry Properties
Last modified
10/12/2020 10:30:43 PM
Creation date
8/5/2020 4:10:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012858
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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EHD - Public
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SPL HOUSTON ENVIRONMENTAL LABORATORY <br /> SAMPLE LOGIN CHECKLIST <br /> DATE: `" Lq q TIME: lq(Do CLIENT NO. <br /> LOT NO. CONTRACT NO. <br /> CLIENT SAMPLE NOS. <br /> SPL SAMPLE NOS. : qvo�33� <br /> YES NO <br /> 1 . Is a Chain-of--Custody form present? <br /> 2. Is the COC properly completed? <br /> If no, describe what is incomplete: <br /> E <br /> If no, has the client been contacted about it? <br /> (Attach subsequent documentation from client about the situation) <br /> 3. Is airbill/pacing ist bill o lade w shipment? 1� <br /> If yes, ID# : <br /> 4 . Is a USEPA Traffic Report present? <br /> 5. Is a USEPA SAS Packing List present? <br /> 5. Are custody seals present on the package? <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 /> 1 l <br /> 1 r r ! t <br /> 9. Condition/temperature of shipping container: <br /> 10. Condition/temperature of sample bottles: <br /> 11 . Sample Disposal? : SPL disposal Return to client ' <br /> NOTES ( reference item number if applicable) : <br /> ATTEST: I I I I DATE': <br /> DELIVERED �ORR�ESOL�UTION�: RECD DATE: <br /> RESOLVED: ' DATE: <br /> �r rI <br />
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