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SU0009809_SSNL
Environmental Health - Public
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EHD Program Facility Records by Street Name
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12 (STATE ROUTE 12)
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5400
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2600 - Land Use Program
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PA-1300168
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SU0009809_SSNL
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Last modified
11/19/2024 3:46:26 PM
Creation date
9/9/2019 10:26:16 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SU0009809
PE
2625
FACILITY_NAME
PA-1300168
STREET_NUMBER
5400
Direction
W
STREET_NAME
STATE ROUTE 12
City
LODI
Zip
95240-
APN
05516072
ENTERED_DATE
10/28/2013 12:00:00 AM
SITE_LOCATION
5400 W HWY 12
RECEIVED_DATE
10/25/2013 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\T\HWY 12\5400\PA-1300168\SU0009809\NL STDY.PDF
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EHD - Public
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1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> M c C a m p b e I l Analytical, Inc. Toll Free Telephone:(877)252-9262/Fax:(925)252-9269 <br /> "When Quality Counts" http://www.mccainpbell.coin/E-mail:main@,rnccwnpbell.com <br /> Sample Receipt Checklist <br /> _ Client Name: Neil O.Anderson&Associates Date and Time Received: 2/19/2015 4:59:36 PM <br /> Project Name: #NA157000;Odyssey Landscape Logln Reviewed by: Jena Alfaro <br /> WorkOrder Ns: 1502678 Matrix: Water Carrier: Daniel(MAI Courier) <br /> Chain of Custody(COC)Information <br /> Chain of custody present? Yes No❑ <br /> Chain of custody signed when relinquished and received? Yes No❑ <br /> Chain of custody agrees with sample labels? Yes No❑ <br /> '— Sample IDs noted by Client on COC? Yes No Ll <br /> Date and Time of collection noted by Client on COC? Yes V No❑ <br /> Sampler's name noted on COC? Yes 0 No❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA❑� <br /> Shipping container/cooler in good condition? Yes No❑ <br /> Samples in proper containers/bottles? Yes No <br /> Sample containers intact? Yes No❑ <br /> Sufficient sample volume for indicated test? Yes No❑ <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? Yes CI No❑ <br /> Sample/Temp Blank temperature Temp: 2°C NA❑ <br /> Water-VOA vials have zero headspace/no bubbles? Yes ❑d No❑ NA❑ <br /> Sample labels checked for correct preservation? Yes F No❑ <br /> pH acceptable upon receipt(Metal:<2;522:<4;218.7:>8)? Yes ❑ No❑ NA d❑ <br /> Samples Received on Ice? Yes ❑ No❑d <br /> UCMR3 Samples: <br /> Total Chlorine tested and acceptable upon receipt for EPA 522? Yes ❑ No❑ NA❑4 <br /> Free Chlorine tested and acceptable upon receipt for EPA 218.7, Yes ❑ No❑ NA <br /> 300.1,537,539? <br /> "NOTE:If the"No"box is checked,see comments below. <br /> Comments: <br /> Page 10 of 10 <br />
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