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Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0539430
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Last modified
2/15/2019 12:06:18 PM
Creation date
2/15/2019 11:41:40 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0539430
PE
2953
FACILITY_ID
FA0022537
FACILITY_NAME
WHITE ARROW LLC
STREET_NUMBER
2402
Direction
S
STREET_NAME
CALIFORNIA
STREET_TYPE
ST
City
STOCKTON
Zip
95206
APN
16707029
CURRENT_STATUS
01
SITE_LOCATION
2402 S CALIFORNIA ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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unS <br /> Laboratories, Inc. rye r of_!_ <br /> VPOVIOINO QVAlJ1Y ANALMGL SPAVNH9 NAT10.YWIEp . <br /> SAMPLE RECEIVING REVIEW SHEET <br /> BATCH# TiNo � <br /> Client Name: Par+ner EL5S SF Project: 2wo7- S. wl(r rn« SAre. S'6ckA-,,(,A <br /> 0.SLob <br /> Received by: Date/Time Received: t{(Lf(114 M <br /> Delivered by: ❑Client ❑ SunStarCourier XCGSO '❑FedEx ❑Other <br /> Total number of coolers received 1 Temp criteria=6°C>0°C(no frozen containers) <br /> Temperature: cooler#1 S"e( °C+/-the CF (-0.2°C) = S i °C corrected temperature <br /> cooler#2 °C+/-the CF (-0.2°C) _ °C corrected temperature <br /> cooler#3 °C+/-the CF (-0.2°C) _ °C corrected temperature <br /> Samples outside temp. but received on ice,who 6 hours of final sampling. KYes []No* ❑N/A <br /> Custody Seals Intact on Cooler/Sample Yes ❑No* ❑N/A <br /> Sample Containers Intact ) Yes ❑No* <br /> Sample labels match COC ID's [' Yes ❑No* <br /> Total number of containers received match COC XYes []No* <br /> Proper containers received for analyses requested on COC X[Yes ❑No* <br /> Proper preservative indicated on COC/containers for analyses requested ❑Yes ❑No* W/A <br /> Complete shipment received in good condition with correct temperatures,containers, labels,volumes <br /> preservatives and within method specified holding times. JYes ❑No* <br /> *Complete Non-Conformance Receiving Sheet if checked Cooler/Sample Review-Initials and date R-1 t t{.(Z,r(lq <br /> Comments: <br />
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