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COMPLIANCE INFO_2016 - 2018
Environmental Health - Public
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EHD Program Facility Records by Street Name
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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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0 SunStar2, 0' n, <br /> Laboratories' <br /> SAMPLE RECEIVING REVIEW SHEET <br /> Batch/Work Order#: <br /> Client Name: Project: / <br /> �g� 6� LSkJY� f4tAO.K4_.0 Pt-9C�_ <br /> Delivered by: ❑Client ❑SunStar Courier ®GSO ❑ FedEx ❑Other <br /> If Courier,Received by: Date/Time Courier <br /> Received: <br /> Lab Received by: Date/Time Lab <br /> &.A,3 Received: Nlrlts .0,00 <br /> Total number of coolers received: ( <br /> Temperature: Cooler#1 s 3 °C+I-the CF( 0.2°C) = s.i 'C corrected temperature <br /> Temperature: Cooler#2 °C+/-the CF(-0.2°C) a °C corrected temperature <br /> Temperature: Cooler#3 OC +/-the CF(-0.2°C) _ 0C corrected temperature <br /> Temperature criteria=:5 VC Within criteria? [R]Yes ❑No <br /> no frozen containers <br /> If NO: <br /> Samples received on ice? ❑Yes []No-� <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 ©Yes ❑No* ❑N/A <br /> Sample containers intact WYes ❑No* <br /> Sample labels match Chain of Custody IDs ®Yes ❑No* <br /> Total number of containers received match COC ®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* E�N/A <br /> Complete shipment received in good condition with correct temperatures, <br /> containers,labels,volumes preservatives and within method specified ® Yes ❑No* <br /> holding times <br /> *Complete Non-Conformance Receiving Sheet ifchecked Cooler/Sample Review-Initials and date: <br /> Comments: <br /> Page 1 of <br />
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