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ARCHIVED REPORTS XR0003535
Environmental Health - Public
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EHD Program Facility Records by Street Name
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C
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COUNTRY CLUB
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2575
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2900 - Site Mitigation Program
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PR0541989
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ARCHIVED REPORTS XR0003535
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Last modified
6/21/2019 9:34:06 PM
Creation date
6/21/2019 3:58:27 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003535
RECORD_ID
PR0541989
PE
2950
FACILITY_ID
FA0024100
FACILITY_NAME
COUNTRY CLUB VALERO
STREET_NUMBER
2575
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
APN
12302012
CURRENT_STATUS
01
SITE_LOCATION
2575 COUNTRY CLUB BLVD
P_LOCATION
01
QC Status
Approved
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EHD - Public
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COOLER RECEIPT FORM <br /> ect: Log No: <br /> oaler, recezve on: <br /> and c ec e on b r <br /> s1g <br /> +ere custody papers present' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . YES NO <br /> sere custody papers properly filled outs . . . . . . . . . . . . . .4ES -NO+ere the custody papers signed' . . . . . . . . . . . . . . . . . . . . . . . NOdas cufficient ice used? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NO Yl <br /> �� `�.�Jy <br /> )id all bottles arrive in good condition (unbroken) ' . . . . . . . Y . NO <br /> )id bottle labels match COC? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NO <br /> vere proper bottles used for analysis indicated? . . . . . . . . . ES NO <br /> lorrect preservatives used' . . . . . . . . . . . . . ES ND <br /> 10A vials checked for headspace bubbles' . . . . . . . . . . . YE NO <br /> Note which voas ( if any) had bubbles: * <br /> Sampl ddescriptor: Numb of vials. <br /> it <br /> W <br /> *All VOAs with headspace bubbles have been set aside so they will not be <br /> used for analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .YES NO <br /> Lj,st here all other fobs received in the same cooler: <br /> Client Job i NET log <br /> r <br /> (coolerrec) <br />
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