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ARCHIVED REPORTS_SITE INVESTIGATION AND WELL DESTRUCTION PERMIT
Environmental Health - Public
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EHD Program Facility Records by Street Name
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24550
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2900 - Site Mitigation Program
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PR0537774
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ARCHIVED REPORTS_SITE INVESTIGATION AND WELL DESTRUCTION PERMIT
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Entry Properties
Last modified
1/29/2020 6:19:39 PM
Creation date
1/29/2020 4:40:58 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
SITE INVESTIGATION AND WELL DESTRUCTION PERMIT
RECORD_ID
PR0537774
PE
2950
FACILITY_ID
FA0021779
FACILITY_NAME
FED X GROUND TRACY PROJECT
STREET_NUMBER
24550
Direction
S
STREET_NAME
HANSEN
STREET_TYPE
RD
City
TRACY
Zip
95377
CURRENT_STATUS
01
SITE_LOCATION
24550 S HANSEN RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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er-acieme <br /> Page 30 of 31 <br /> WORK ORDER M 14-05-� <br /> CLIENT: LRS Cooler-L of <br /> TEMPERATURE: Thermometer ID: sc2 (Criteria: o.o°C- DATE: 0512-2--114 <br /> Temperature 2 . o 6.0°C, not frozen except sedimerif/tissue) <br /> _ C - 0.30 C (CF) °C <br /> � <br /> ❑ Sample(s)outside temperature criteria (PM/APM Blank ❑ Sample <br /> contacted by: <br /> ❑ Sample(s)outside temperature criteria but received on ice/chilled on same day of sampling. <br /> ❑ Received at ambient temperature, placed on ice for transport by Courier. <br /> Ambient Temperature: ❑ Air ❑ Filter <br /> Checked by: <br /> CUSTODY SEALS INTACT: <br /> ."Cooler ❑ <br /> ❑ Sample ❑ <br /> — ❑ No (Not Intact) N t Present ❑ N/A Checked by: 46 <br /> ❑ No (Not.Intact) ❑ Not Present <br /> Checked by: `lZd <br /> SAMPLE CONDITION: <br /> Chain-Of-Custody(COC) document(s) received with samples.......,, Yes No N/A <br /> COC documents) received complete......................... ❑ ❑ <br /> lection datffe/time, matrix,andlor#of containers logged in based on sample labels. <br /> .........bels.. ❑ <br /> ❑ No analysis requested. ❑Not relinquished. ❑No date/time relinquished. <br /> Sampler's name indicated on COC....... L <br /> Sample container label(s) consistent with COC.................................... ❑ ❑ ❑ <br /> Sample container(s) intact and good condition...................................... ❑ <br /> Proper containers and sufficient volume for analyses requested............... <br /> ❑ ❑ <br /> Analyses received within holding time............. El ❑ <br /> Aqueous samples received within 15-minute holding time ❑ <br /> E3 pH ❑ Residual Chlorine ❑ Dissolved Sulfides ❑ Dissolved Oxygen........... ❑ <br /> Proper preservation noted on COC or sample container.......................... El <br /> ❑ Unpreserved vials received for Volatiles analysis ❑ <br /> Volatile analysis container(s) free of headspace............................... . <br /> Tedlar bag(s)free of condensation.............. ❑ ❑ <br /> CONTAINER TYPE: ❑ <br /> ❑ <br /> Solid: 0401 08ozCGJ 016ozCGJ <br /> Aqueous: ❑VOA ❑VOAh ❑VOAna2 ❑125A�❑125A Bh ❑1eve ❑25AGBp ❑1AGBr❑1AGBna❑ <br /> ❑500AGB 0500AGJ 0500AGJs 0250AGB ❑250CGB 0250CGBs ❑1PB 2 ❑00PBs <br /> ❑250PB 0250PBn ❑125P6 ❑125PBznna ❑100PJ ❑100PJna2 ❑ ❑1PBna ❑500PB <br /> Air: ❑Tedlar® ❑Canister Other: ❑ ❑ ❑ <br /> Container: C:Clear A:Amber P:Plastic G:Glass J:Jar g:gottlepZB:Zpoc/Reslank Oealable g Labeled/Checked by. <br /> Preservative: h:HCL n:HI naz:Na25z0a na:N'CH p:HaPO4 s:HzSOI u:Ultra-pure znna:ZnAc,+NaOH f:Filtered Scanned by:;7� <br /> p s E:Envelope Reviewed by:�Z <br /> -Z� <br /> SOP T100_090(07131113) <br />
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