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COMPLIANCE INFO_2016 - 2018
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0506538
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COMPLIANCE INFO_2016 - 2018
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Entry Properties
Last modified
4/1/2020 11:52:24 AM
Creation date
11/8/2018 9:47:44 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2016 - 2018
RECORD_ID
PR0506538
PE
2361
FACILITY_ID
FA0007486
FACILITY_NAME
COUNTRY MARKETPLACE
STREET_NUMBER
1789
Direction
W
STREET_NAME
CHARTER
STREET_TYPE
WAY
City
STOCKTON
Zip
95206
APN
16337023
CURRENT_STATUS
01
SITE_LOCATION
1789 W CHARTER WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Supplemental fields
FilePath
\MIGRATIONS3\C\CHARTER\1789\PR0506538\COMPLIANCE INFO 2016 - PRESENT.pdf
QuestysFileName
COMPLIANCE INFO 2016 - PRESENT
QuestysRecordDate
11/18/2016 5:11:43 PM
QuestysRecordID
3261353
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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SunStar � , <br /> tl� 20y,.,s. <br /> %01 Laboratories <br /> SAMPLE RECEIVING REVIEW SHEET <br /> Batch/Work Order#: T181190 <br /> Client Name: Gribi Associates Project: Country Market Place <br /> Delivered by: ❑ Client ❑ SunStar Courier [N GSO ❑ FedEx ❑ Other <br /> If Courier, Received by: Date/Time Courier <br /> Received: <br /> Lab Received by: Dan Date/Time LabReceived: 4-7-18 9:12 <br /> Total number of coolers received: 1 <br /> Temperature: Cooler#l 3.2 °C +/-the CF(-0.2°C) = 3.0 °C corrected temperature <br /> Temperature: Cooler#2 °C +/-the CF(-0.2°C) = °C corrected temperature <br /> Temperature. Cooler#3 °C +/-the CIF(-0.2°C) = °C corrected temperature <br /> Temperature criteria=5 6°C Within criteria? ®Yes [—]No <br /> no frozen containers <br /> If NO: <br /> Samples received on ice? ❑Yes []No 4 <br /> Complete Non-Conformance Sheet <br /> If on ice, samples received same day ❑No 4 <br /> collected? ❑Yes Acceptable Complete Non-Conformance Sheet <br /> Custody seals intact on cooler/sample 4Yes ❑No* ❑NIA <br /> Sample containers intact ®Yes ❑No* <br /> Sample labels match Chain of Custody IDs [ Yes ❑No* <br /> Total number of containers received match COG ®Yes ❑No* <br /> Proper containers received for analyses requested on COC ®Yes ❑No* <br /> Proper preservative indicated on COC/containers for analyses requested ❑Yes []No* ON/A <br /> Complete shipment received in good condition with correct temperatures, <br /> containers, labels,volumes preservatives and within method specified © yes ❑1110* <br /> holding times <br /> *Complete Non-Conformance Receiving Sheet if checked Cooler/Sample Review- Initials and date: -�-1� <br /> Comments: <br /> Page 1 of 1 <br />
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