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ARCHIVED REPORTS Second Quarter 2011
Environmental Health - Public
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EHD Program Facility Records by Street Name
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A
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ALPINE
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75
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2900 - Site Mitigation Program
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PR0526874
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ARCHIVED REPORTS Second Quarter 2011
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Last modified
11/1/2018 2:30:59 PM
Creation date
11/1/2018 8:48:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS Second Quarter 2011
FileName_PostFix
Second Quarter 2011
RECORD_ID
PR0526874
PE
2960
FACILITY_ID
FA0018201
FACILITY_NAME
FORMER MOBIL SERVICE STATION 99-CAS
STREET_NUMBER
75
Direction
E
STREET_NAME
ALPINE
STREET_TYPE
AVE
City
STOCKTON
Zip
95204
APN
11514007
CURRENT_STATUS
01
SITE_LOCATION
75 E ALPINE AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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Cum L1qCj9rTCV <br />vfro "ar�iai <br />'17A.Sbarato e's, <br />CLIENT: C P4N-0 e7l-f' <br />Page 42 of 43 <br />WORK ORDER #: I 1-05-0 ® 0 0 <br />Cooler Z of v <br />DATE: OJT /Z+ /i i <br />TEMPERATURE: Thermometer ID: SCI (Criteria: 0.0 OC — 6.0'c, not frozen) <br />Temperature i .Q OC + 0.50C (CF) = / . U—OC wank ❑ Sample <br />❑ Sample(s) outside temperature criteria (PM/APM contacted by: ). <br />❑ Sample(s) outside temperature criteria but received on ice/chilled on same day of sampling. <br />❑ Received at ambient temperature, placed on ice for transport by Courier. <br />Ambient Temperature: ❑ Air ❑ Filter <br />Initial: <br />CUSTODY SEALS INTACT: <br />2'C"ooler ❑ ❑ No (Not Intact) ❑ Not Present ❑ N/A Initial: <br />❑ Sample ❑ ❑ No (Not Intact) ZNot Present, Initial: PT <br />SAMPLE CONDITION: Yes <br />No <br />N/A <br />Chain -Of -Custody (COC) document(s) received with samples ................... <br />El <br />❑ <br />❑ <br />COC document(s) received complete ................................................... <br />❑ <br />❑ <br />❑ Collection date/time, matrix, and/or # of containers logged in based on sample labels. <br />❑ No analysis requested. ❑ Not relinquished. ❑ No date/time relinquished. <br />/ <br />Sampler's name indicated on COC ...................................................... <br />2( <br />❑ <br />❑ <br />Sample container label(s) consistent with COC ..................... I................ <br />2-1*' <br />❑ <br />❑ <br />Sample container(s) intact and good condition ....................................... <br />011 <br />❑ <br />❑ <br />Proper containers and sufficient volume for analyses requested ................ <br />❑ <br />❑ <br />Analyses received within holding time .................................................. <br />❑ <br />❑ <br />pH / Res. Chlorine / Diss. Sulfide / Diss. Oxygen received within 24 hours... <br />El <br />Z/ <br />Proper preservation noted on COC or sample container .......................... <br />FIK <br />❑ <br />❑ <br />❑ Unpreserved vials received for Volatiles analysis <br />Volatile analysis container(s) free of headspace..................................... <br />2' <br />❑ <br />❑ <br />Tedlar bag(s) free of condensation...................................................... <br />❑ <br />❑ <br />CONTAINER TYPE: <br />Solid: 1140ZCGJ q8ozCGJ 016ozCGJ ❑Sleeve (_) ❑EnCorese ❑TerraCorese ❑ <br />/2 <br />Water: <br />EI ON Ah 0V0Ana2 ❑125AGB ❑125AGBh 0125AGBp ❑1AGB ❑1AGBna2 01AGBs <br />0500AGB C(500AGJ 0500AGJs ❑250AGB ❑250CGB ❑250CGBs ❑1PB 0500PB 0500PBna <br />0250PB 2 250PBn ❑ 125PB ❑ 125PBznna ❑ 100PJ ❑ 100PJna2 ❑ ❑ ❑ <br />Air: ❑Tedlaro ❑Summa° Other: ❑ Trip Blank Lot#: Labeled/Checked by: `P <br />Container: C: Clear A: Amber P: Plastic G: Glass J: Jar B: Bottle Z: Ziploc/Resealable Bag E: Envelope Reviewed by: <br />Preservative: h: HCL n: HN% nai:N612S203 na: NaOH p: H3PO4 s: H2SO4 znna: ZnAc2+NaOH f. Field -filtered Scanned by: <br />SOP T100_090 (03124111) <br />
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