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SR0080888 SSNL
Environmental Health - Public
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2600 - Land Use Program
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SR0080888 SSNL
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Entry Properties
Last modified
11/25/2020 12:02:09 PM
Creation date
12/27/2019 9:34:24 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL
RECORD_ID
SR0080888
PE
2602
FACILITY_NAME
PHRABUDDHIVONGSAMUNEE BUDDHIST TEMPLE
STREET_NUMBER
11253
Direction
N
STREET_NAME
THORNTON
STREET_TYPE
RD
City
LODI
Zip
95219
APN
05520003
ENTERED_DATE
7/15/2019 12:00:00 AM
SITE_LOCATION
11253 N THORNTON RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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j 1534 Willow Pass Road,Pittsburg,CA 94565-1701 <br /> M C C a m p b e 11 Analytical, InC. To 1 <br /> 1 Frec Telephone:(977)252-9262/Fax:(925)252-9269 <br /> "When Quality Counts" hup://www.inccampbe11.coin F.-mail:main(omccampbell.com <br /> Sample Receipt Checklist <br /> Client Name: Terracon Date and Time Received 5/10/2019 14:04 <br /> Project: NAI 77056;Buddhist Temple Date Logged: 5/10/2019 <br /> Received by: Kena Ponce <br /> WorkOrder Ns: 1905588 Matrix: Water Logged by: Kena Ponce <br /> Carrier: Patrick Johnson(MAI Courier) <br /> Chain of Custody(COC)Information <br /> Chain of custody present? Yes W No❑ <br /> Chain of custody signed when relinquished and received? Yes No❑ <br /> Chain of custody agrees with sample labels? Yes 0 No❑ <br /> Sample IDs noted by Client on COC? Yes kl No❑ <br /> Date and Time of collection noted by Client on COC? Yes W No❑ <br /> Sampler's name noted on COC? Yes W No❑ <br /> COC agrees with Quote? Yes ❑ No❑ NA d❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No ❑ NA <br /> Shipping container/cooler in good condition? Yes d❑ No❑ <br /> Samples in proper containers/bottles? Yes W No❑ <br /> Sample containers intact? Yes W No❑ <br /> Sufficient sample volume for indicated test? Yes W No❑ <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? Yes ❑d No❑ NA❑ <br /> Samples Received on Ice? Yes W No❑ <br /> (Ice Type: WET ICE ) <br /> Sample/Temp Blank temperature Temp: 4.4°C NA❑ <br /> Water-VOA vials have zero headspace/no bubbles? Yes 0 No❑ NA❑ <br /> Sample labels checked for correct preservation? Yes ❑d No❑ <br /> pH acceptable upon receipt(Metal: <2; Nitrate 353.2/4500NO3: Yes ❑ No❑ NA❑d <br /> <2; 522:<4;218.7:>8)? <br /> UCMR Samples: <br /> pH tested and acceptable upon receipt(200.8::52;525.154; Yes ❑ No❑ NA W <br /> 530:<_7;541:<3;544:<6.5&7.5)? <br /> Free Chlorine tested and acceptable upon receipt(<0.lmg/L)? Yes ❑ No❑ NA W <br /> Comments: <br /> D-- <br />
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