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ARCHIVED REPORTS XR0007239
Environmental Health - Public
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EHD Program Facility Records by Street Name
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WATERLOO
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6732
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3500 - Local Oversight Program
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PR0544809
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ARCHIVED REPORTS XR0007239
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Last modified
9/5/2019 11:42:27 AM
Creation date
9/5/2019 11:34:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007239
RECORD_ID
PR0544809
PE
3526
FACILITY_ID
FA0004030
FACILITY_NAME
THREE PALMS GROCERY
STREET_NUMBER
6732
Direction
E
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95215
APN
10110001
CURRENT_STATUS
02
SITE_LOCATION
6732 E WATERLOO RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\wng
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EHD - Public
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Argon 'Laboratories Sample Receipt Checklist <br /> Client Name ATC Associates, Inc Date&Time Received 4/1312005 1120 <br /> Project Name Bozzano Property Client Project Number 54 17861 0001 <br /> Received By E P Matrix Water 0 Soil ❑ <br /> Sample Carrier Client ❑ Laboratory 0 Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number F04381 <br /> S7,cper Conianer in good condition? Samples received in proper containers? Yes ❑ No ❑ <br /> NIA Yes ❑ No ❑ Samples received intact? Yes 0 No ❑ <br /> Samples received under refrigeration? Yes ❑ No ❑ Sufficient sample volume for requested tests?Yes No ❑ <br /> Cham of custody present? Yes 0 No ❑ Samples received within holding time? Yes 0 No ❑ <br /> Cham of Cuslooy signed by all parties? Yes 7 No ❑ Do samples contain proper preservative? <br /> NIA ❑ Yes 0 No ❑ <br /> Chan of Custody matches akl sample labels? Do VOA vials contain zero headspace'? <br /> Yes 0 No ❑ (None submitted ❑) 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 /> Ccmments <br /> Action Taken <br /> ADDITIONAL TEST(S)REQUEST 1 OTHER <br /> Contacted By Date Time <br /> Call Received By <br /> Comments <br />
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