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ARCHIVED REPORTS_XR0002366
Environmental Health - Public
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EHD Program Facility Records by Street Name
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G
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GRANT LINE
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15
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3500 - Local Oversight Program
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PR0545195
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ARCHIVED REPORTS_XR0002366
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Entry Properties
Last modified
1/23/2020 3:17:36 PM
Creation date
1/23/2020 2:49:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002366
RECORD_ID
PR0545195
PE
3528
FACILITY_ID
FA0002915
FACILITY_NAME
TRACY MARKET INC
STREET_NUMBER
15
Direction
E
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
21435004
CURRENT_STATUS
02
SITE_LOCATION
15 E GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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Amon Laboratories Sample Receipt Checklist <br /> CC <br /> Client Name AIV, JJ ) _ J lZZ �1 j j <br /> DaYP&"rima PPyo—nd <br /> Project Name � �1`} e r �, v �3 <br /> ..._. Client Protect Number <br /> Ri9ceiveo By 61B Matnx Water E�Z Soil ❑ Other _ <br /> Sample Carne Client ❑ Laboratory Fed Ex ❑ UPS71❑ Other <br /> Argon Labs Project Number Zd:IQ <br /> Shipper Container in g000 condition? Sufficient sample volume for requested tests?Yes No !J <br /> N/A [E� Yes El No ❑ Samples received within holding time? Yes EI/ No ❑ <br /> SamDles received under refrigeration? Yes L No ❑ Do samples contain proper preservative? <br /> N/A ❑ Yes 1:9'/ No F-1Chain of cus ody present? Yes � No ❑ VOA?sols with preservative? <br /> NIA El Yes 12Z, No E-1Ghain or Custcoy signed by all Darties? Yes No ❑ VOA vials preservative type <br /> HCL Ej Na2S203 ❑ Other <br /> Cham of Custody maiches all sample labels? Do VOA vials contain zero headspace? <br /> Yes EP/ No ❑ N/A ❑ Yes No ❑ <br /> Sanples recei ped in proper containers? Yes E No ❑ 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 /> Ac,ion Taken <br /> ADDITIONAL TEST(S)REQUEST!OTHER <br /> Contacted By Date Time <br /> Call Received By <br /> Comments <br /> v 5 02 <br />
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