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COMPLIANCE INFO_PRE 2019
Environmental Health - Public
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EHD Program Facility Records by Street Name
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P
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PICCOLI
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1990
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2200 - Hazardous Waste Program
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PR0514089
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
1/5/2022 2:43:26 PM
Creation date
11/1/2018 4:24:00 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0514089
PE
2247
FACILITY_ID
FA0003826
FACILITY_NAME
Supervalu
STREET_NUMBER
1990
Direction
N
STREET_NAME
PICCOLI
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
10121001
CURRENT_STATUS
01
SITE_LOCATION
1990 N PICCOLI RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\kblackwell
Supplemental fields
FilePath
\MIGRATIONS\P\PICCOLI\1990\PR0514089\RTC 4_18_08 INSPECTION\RTC 4_18_08 INSPECTION.PDF
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EHD - Public
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�;•ti'eurofins <br />Calscience <br />CLIENT: 11,1,4 0 �/,I <br />Page 25 of 25 <br />WORK ORDER #: 14-07-®® u 4 <br />In Cooler of / <br />DATE: 0 % / 14 <br />TEMPERATURE: Thermometer ID: SC1 (Criteria: 0.0 OC — 6.0 OC, not frozen except se e�htGti s ff <br />�j <br />C <br />Temperature 0 C 0.3 0 C (CF) 0 C flank L1 Sample <br />❑ Sample(s) outside temperature criteria (PM/APM contacted by: ) SEP 19 2014 <br />❑ Sample(s) outside temperature criteria but received on ice/chilled on same day of sampl9�41VIRONMENTAL 1 <br />❑ Received at ambient temperature, placed on ice for transport by Courier. DEPARTMEN <br />Ambient Temperature: 11Air ElFilter Checked by: 6.7Y <br />CUSTODY SEALS INTACT: <br />❑ Cooler ❑ ❑ No (Not Intact) Not Present ❑ N/A Checked by:�' <br />❑ Sample ❑ ❑ No (Not Intact) mel Not Present Checked by:�i <br />SAMPLE CONDITION: <br />Yes <br />No <br />N/A <br />Chain -Of -Custody (COC) document(s) received with samples...................�� <br />i <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 />Sampler's name indicated on COC ..................................................... <br />¢ <br />❑ <br />❑ <br />Sample container label(s) consistent with COC ..................................... <br />❑ <br />❑ <br />Sample containers) intact and good condition ...................................... <br />❑ <br />❑ <br />Proper containers and sufficient volume for analyses requested ...............] <br />❑ <br />❑ <br />Analyses received within holding time ................................................. <br />❑ <br />❑ <br />Aqueous samples received within 15 -minute holding time <br />❑ pH ❑ Residual Chlorine ❑ Dissolved Sulfides ❑ Dissolved Oxygen........... <br />❑ <br />❑ <br />Prooer preservation noted on COC or sample container ........................../E� <br />❑ <br />❑ <br />❑ Unpreserved vials received for Volatiles analysis <br />Volatile analysis container(s) free of headspace..................................... <br />❑ <br />❑ <br />Tedlar bag(s) free of condensation...................................................... <br />❑ <br />❑ <br />Ile <br />CONTAINER TYPE: <br />Solid: ❑4ozCGJ ❑80ZCGJ ❑16ozCGJ ❑Sleeve ( ) ❑EnCoreso <br />❑TerraCores° <br />❑ <br />Aqueous: ❑VOA fTVOAh ❑VOAna2 ❑125AGB ❑125AGBh ❑125AGBp ❑1AGB 71AGBna2 ❑1AGBs <br />❑500AGB,Z500AGJ ❑500AGJs 0250AGB ❑250CGB ❑250CGBs ❑1PB 01PBna d500PB <br />❑250PB /50PBn 0125PB ❑125PBznna ❑100PJ ❑100PJna2 ❑ ❑ ❑ <br />Air: ❑Tedlarc ❑Canister Other: ❑ Trip Blank Lot#: Labeled/Checked by: `Z - <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: HNO3 na2:Na2S203 na: NaOH p: H3PO4 s: H2SO4 u: Ultra -pure znna: ZnAc2+NaOH f: Filtered Scanned by: 10q) <br />SOP T100_090 (06/02/14) <br />
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