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ARCHIVED REPORTS XR0000672
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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CAPITOL
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6421
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2900 - Site Mitigation Program
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PR0522496
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ARCHIVED REPORTS XR0000672
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Entry Properties
Last modified
2/15/2019 6:13:55 PM
Creation date
2/15/2019 3:24:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000672
RECORD_ID
PR0522496
PE
2957
FACILITY_ID
FA0015317
FACILITY_NAME
FLAG CITY CHEVRON
STREET_NUMBER
6421
STREET_NAME
CAPITOL
STREET_TYPE
AVE
City
LODI
Zip
95245
APN
05532024
CURRENT_STATUS
02
SITE_LOCATION
6421 CAPITOL AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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• Brooks Rand LLC Sample Receiving Log <br /> Tracking# 02BR293 Due Date 6(19/02 <br /> Receiving Date 611 aM2 <br /> Customer McCampbeil AnalyfJcal <br /> Receiving Time 9 00 AM <br /> Contact Michelle Miller Logged-in by, Frank McFarland <br /> Project Ref # MCAoo1 Log-In Date 6/18/02 <br /> Collection Date 6/17/02 Logon Time 10 30 AM <br /> QA Level Standard Airbill present? Yes <br /> Sample Condition Intact Alrbilt# lzf7371021100001 <br /> Shipping container intact? Yes <br /> Garner UPS <br /> Shipping container type cooler Custody seal present? Yes <br /> Shipping container temp 1 39C. Custody seal intact? Yes <br /> COC Present? Yes <br /> Shipping container coolant ice <br /> CDC Number N/A <br /> Sample preservabon 0 5%BrCI Arailysis request form? No <br /> Add Eats# 02-1 o8-arCl <br /> Hg Concentration COC/Sample tag agree? Yes <br /> Sample storage area Cabinet#2 See SOW No See Project Manager No <br /> See Memo No See Lab Manager No <br /> Sample Turnaround Time Consult MSDS No See Contract Info No <br /> Contract Turnaround Time 1 days <br /> • Comments <br /> ............................................................................................................................................................ <br /> Lab ID Sample Tag# Container# Size pH Matnx/Sub-Matrix Comments <br /> 1 Effluent BR-333 250 mL Bottle <2 Water,Effluent <br /> Analysis/Method Hg EPA 1631 Mod 2 <br /> --------------------------------------- <br /> I;662 <br /> sampre Custodian signature Date <br /> Page 1 of 1 <br />
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