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ARCHIVED REPORTS XR0000727
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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CAMBRIDGE
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16470
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3500 - Local Oversight Program
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PR0544155
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ARCHIVED REPORTS XR0000727
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Last modified
2/15/2019 4:05:18 PM
Creation date
2/15/2019 1:55:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000727
RECORD_ID
PR0544155
PE
3526
FACILITY_ID
FA0000185
FACILITY_NAME
CITY GAS & LIQUOR
STREET_NUMBER
16470
STREET_NAME
CAMBRIDGE
STREET_TYPE
ST
City
LATHROP
Zip
95330
APN
19643032
CURRENT_STATUS
02
SITE_LOCATION
16470 CAMBRIDGE ST
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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EMS STL <br /> STL San Francisco <br /> Sfample Receipt Checklist <br /> �/ <br /> Submission #;2003- - d ` 3,T <br /> Checklist Y (initials3 b completed Date lb—,L /2103 <br /> ID3 <br /> p <br /> Couner name a STL San Francisco E3 Client <br /> Not <br /> Custody seals intact on shipping container/samples Yes No Present <br /> Chain of custody present? Yes__L__Vo <br /> Chain of custody signed when relinquished and received? Yes___L,--No <br /> Chain of custody agrees with sample labels? Yes Na <br /> Samples in proper containertbottle') Yes r No <br /> Sample containers intact? Yes �No <br /> Sufficient sample volume for indicated tests Yes '�No _ <br /> All samples received within holding time? Yes�No <br /> ContainerlTemp Blank temperature to compliance(40 C t 2)'? Temp Yes No <br /> Ice Present Yes_ /� <br /> Water-VOA vials have zero headspace? No VOA vials submitted Yeses No <br /> (if bubble is present,refer to approximate bubble size and itemize in comments as 5 (small-O),M (medium- O)or L(large-- O) <br /> Water-pH acceptable upon receipt? es Cl No <br /> ❑ pH adjusted- Preservative used ❑HNO3❑ HCl❑ H2SO4 ❑ NaOH ❑ZnOAc-Lot#(s) <br /> For any item check-listed "No provided detail of discrepancy in comment section below <br /> Comments- <br /> Project Management [Routing for instruction of indicated discrepancy(ies)] <br /> Project Manager (inibals) Date t03 <br /> Client contacted ❑ Yes © No <br /> Summary of discussion <br /> Corrective Action(per PM/Client) <br />
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