My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
FIELD DOCUMENTS
Environmental Health - Public
>
EHD Program Facility Records by Street Name
>
E
>
ELEVENTH
>
7675
>
3500 - Local Oversight Program
>
PR0544802
>
FIELD DOCUMENTS
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
11/19/2024 10:19:47 AM
Creation date
9/4/2019 11:28:54 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0544802
PE
3528
FACILITY_ID
FA0005153
FACILITY_NAME
FAYETTE MANUFACTURING CORP
STREET_NUMBER
7675
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
25014012
CURRENT_STATUS
02
SITE_LOCATION
7675 W ELEVENTH ST
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\wng
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
152
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
V <br /> Ar on laboratories Sample Receipt Checklist <br /> _ n Date&Time Received: 1 Z lc.o <br /> Pf0'ECf Idc('tE: �+ t.UU t� .Y� �__ <br /> -----� -^�" Client Protect Number" 60 1 Doc) <br /> Received ey:L'i drt21 O t0�A L-V-2.IN Matrix: Water Soil ❑ Other <br /> Samp!e Ca!ri-�r: Client Laboratory ❑ Fed Ex ❑ UPS ❑ Other ❑ <br /> Arac:n Labs Project Number._G2 Le 0!L) 72 <br /> Shipper Container in good condition? Sufficient sample volume for requested tests?Yes .CE� No <br /> NIA ❑ Yes No ❑ Samples received v✓ithin holding time? Yes .a No <br /> Samples received under refrigeration? .Yes NO ❑ Do samples contain proper preservative? <br /> N/A E) Yes <br /> Chai;;cf;usl)dy present? Yes �] No 10 VOA vials with preservative? <br /> NIA [] Yes .�' NoI i <br /> Chain of Custody signed by all parties? Yes A No EJVOA vials preservative type: <br /> HCL J2' .Na2S2O3 <br /> Chain of Cussodymatches all sample labels? Do VOA vials contain zero headspace? <br /> Yes ,❑ No ❑ NLA ❑ Yes [j ;; [J <br /> Samples received in proper containers?Yes Na ❑ Samples received intact? Yes No ❑ <br /> _ ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted: Person Contacted: <br /> Contacted By: Subject: <br /> Comments: <br /> Action Talo en: <br /> ADDITIONAL TEST(S)REQUEST I OTHER <br /> Contacted:fay: Date: Time: <br /> Call Received By: <br /> Comments: <br /> v.5.02 <br />
The URL can be used to link to this page
Your browser does not support the video tag.