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ARCHIVED REPORTS XR0001135
Environmental Health - Public
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EHD Program Facility Records by Street Name
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D
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DR MARTIN LUTHER KING JR
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620
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3500 - Local Oversight Program
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PR0544216
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ARCHIVED REPORTS XR0001135
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Entry Properties
Last modified
3/4/2019 10:18:01 PM
Creation date
3/4/2019 3:37:28 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001135
RECORD_ID
PR0544216
PE
3528
FACILITY_ID
FA0003738
FACILITY_NAME
CHARTER WAY SHELL*
STREET_NUMBER
620
Direction
W
STREET_NAME
DR MARTIN LUTHER KING JR
STREET_TYPE
BLVD
City
Stockton
Zip
95206
APN
16504007
CURRENT_STATUS
02
SITE_LOCATION
620 W DR MARTIN LUTHER KING JR BLVD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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a <br />[. COOLER RECEIPT FORM <br />�)ect <br />oler received on <br />Log No <br />c ec e on II i c �Li_ by_� <br />(signature) <br />ere <br />OA 1 <br />custody papers present' <br />YES <br />NO <br />re <br />custody papers )roperly Zillea out' <br />YES <br />NO <br />ere <br />the custody papers signed' <br />YES <br />NO <br />as <br />sufficient ice used"' <br />YES <br />NO <br />)Ld <br />all bottles arrive in good condition (unbroken)' <br />YES <br />NO <br />)id <br />bottle labels match COC' <br />YES <br />NO <br />+ere <br />proper bottles used for analysis indicated' <br />YES <br />NO <br />orrect <br />preservatives used' <br />YES <br />NO <br />h k d f heads ace bubbles' <br />YE,S <br />NO <br />V I a s c ec e or p <br />Note which voas (if any) had bubbles <br />ample descriptor number of vials <br />-ill VOAs with headspa�e bubbles have peen set aside so they ill not be <br />used for analysis zES NO <br />[gist here all other fobs received in the same cooler, <br />Client Job # NET log # <br />rrj L4r <br />0 (coolerrec) <br />
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