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ARCHIVED REPORTS XR0007246
Environmental Health - Public
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EHD Program Facility Records by Street Name
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W
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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 XR0007246
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Entry Properties
Last modified
9/5/2019 11:48:52 AM
Creation date
9/5/2019 11:35:53 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007246
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
Tags
EHD - Public
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Amon Laboratories Sample Receipt Checklist <br /> • Cliert Name 4_ G Date&Time Received 1 103 '3 50 <br /> Project Name Jo Z Zcrno _Yrp� Client Project Number y , i y6S <br /> Received By C_ Matrix Water ! Soil 1 <br /> Sample Camer Client 1 aborato 1 FedEx ! UPS 1 <br /> Argon Labs Project Number ��3 Z q f <br /> Shipping Container(Cooler in good condition? Samples received in proper containers? Yes, . No <br /> NIA X Yes No Samples received intact? Yeses[_ No <br /> Samples received under refrigeration? Sufficient sample volume for requested tests? <br /> Yes No Yes X No <br /> Chain of Custody Present? Yes_ No Samples received within holding time? YesL No <br /> Cham of Custody signed by ail parties? Do samples contain proper preservative? <br /> Yes � No NIA Yes-111— No <br /> Chain of Custody matches all sample labefs? Do VOA vials contain zero headspace? <br /> Yes e�` 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 /> Comments <br /> Pct on Taken <br /> --- - - - - - - - - -- _ _ --- _ _ - _ . - -OTHER - - - - - - - � - - - - - --- - _ ..._ _ _ ._ <br /> Date Client Contacted Person Contacted <br /> Co nmenls <br />
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