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ARCHIVED REPORTS XR0001158
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 XR0001158
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Entry Properties
Last modified
3/4/2019 10:38:53 PM
Creation date
3/4/2019 3:47:33 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001158
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
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Tags
EHD - Public
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COOLER RECEIPT FORM <br /> oject: �5�?`6I�J -G og No: <br /> ooler receive on: ____and checked on y <br /> e <br /> i <br /> Were custody papers present? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0 S NO <br /> Were custody papers :properly filled out? . . . . . . . . . . . . . . . . . . . E NO <br /> Were the custody papers signed? . . . . . . . . . . . . . . . . . . . . . . . . . . . E NO j�6 <br /> V <br /> Was sufficient ice used? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NO <br /> V <br /> i <br /> Did all bottles arrive in good condition (unbroken) ? . . . . . . . NO <br /> Did bottle labels match COC? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NO <br /> 1 ` <br /> Were proper bottles used for analysis indicated? NO <br /> Correct preservatives used? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . E NO } <br /> VOA vials checked for headspace bubbles? . . . . . . . . . . . . . . . . . . . NO <br /> Note which voas ( if any) had bubble-s: * <br /> Sample descriptor: Numb r of vials : <br /> I <br /> ID <br /> i <br /> r <br /> 4 <br /> *All VOAs with headspace bubbles have been set aside so they will not be <br /> used for analysis .! . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . YES NO <br />� r <br /> i List here all otherjobsreceived in the same cooler: <br /> f Client Job # NET log . # <br /> i� <br /> 4 <br /> i <br /> 1 <br /> I <br /> I (coolerrec) <br /> k �,✓ i <br /> 4 <br /> r <br /> 1j <br /> I <br /> 1 <br />
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