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ARCHIVED REPORTS_XR0002939
Environmental Health - Public
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EHD Program Facility Records by Street Name
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H
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HAMMER
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3202
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3500 - Local Oversight Program
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PR0545250
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ARCHIVED REPORTS_XR0002939
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Entry Properties
Last modified
1/30/2020 6:25:27 PM
Creation date
1/30/2020 4:18:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002939
RECORD_ID
PR0545250
PE
3528
FACILITY_ID
FA0001817
FACILITY_NAME
7-ELEVEN INC #35355
STREET_NUMBER
3202
Direction
W
STREET_NAME
HAMMER
STREET_TYPE
Ln
City
Stockton
Zip
95209
CURRENT_STATUS
02
SITE_LOCATION
3202 W Hammer Ln
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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STL <br /> �STL San Francisco <br /> Sample Receipt Checkisst <br /> Submission # 24134- /f;P <br /> C.her•klist compicted by (initials) � Dala <br /> Courier 11dr11e STL San Francisco a Client <br /> Not <br /> C€jstorly rnl int:rt on shipping con#dsnerlsamples Yes Nr,— Present <br /> Chari of cu4Mdy prL'sent> Yes �No_ <br /> Chan of custrady sirined rrl7Pn relrrigr€rq;hed and rc�rnsved? Yes`i Nr� <br /> Chain -it custody agrees wdhample labels? Yes No <br /> Sa"nples rat 1'"rnprr container/bottle? Yee No <br /> SamfOe crarstacoei s rnlact' Yt's r Na <br /> Sertllcsent ,ample volume fci indicated test? Yeses No <br /> All sarttplas received evrntltrn holding 11€11e7 Yes„,, No <br /> G�.;^pi Lk tnret''an^;tt-nt»aKe�+l'�r/-7er7"lp'r rti l •ti�.¢((i�y1�tr-j��'Stw N iei Q"a "'.=t_,rftr.lA,g' , =k.teinpeitloll 74rn�lcu't.Te'r.i�:.�c.rj <br /> tr" o "'t� <br /> ~4 <br /> reason farGr � .�Ppougx <br /> � � 0 ry<r�.a�i,:�Y✓�I�' <br /> ^xT1 <br /> fe <br /> kmpled;�4hrlago'�E=1a��rie st it ��att�SrtICserrlP ' Cf`rl !" `�, ,� � - +rrr�' �. =_ <br /> r r t -- w� -•• ar ;L�" sr M.x � rc� �rw,r�" ��, �VL ka^"s wrn' r- - t� ... pr e <br /> __ Yj I' '1� rx �, R>�h Myyr� Chu¢ •C =Y Ia. i 4'ww S <br /> Sd�� ii .✓� �µ ' � wi.....�.x'k L , �� r _�i � AMM <br /> e y ^ "t�rG'�$11��. �RSP'�',t'St�r",,.. <br /> 'Haler- VGA vials liave,zeros headspece? No VDA vials submitted Yes_,�No_ <br /> (if nubble in present,refer to approximate Nubble sire and sterile in comments as S(small -0) M(medium- 0)ar L Marge- 0) <br /> Water-pH acceptable upon receipt? ©Yes 0 No <br /> D pH adjusted- Preservative used. ❑HN030 FICI 0 HZS04© NaOH ©?nOAc-Lot#(S) <br /> For any rtern check-listed "No",provided detait of discrepancy in comment soctran below i <br /> i <br /> Comments <br /> t <br /> Project Management [Routing for instruction of indicated discrepancy(ies)] <br /> i <br /> Project Manager (initials) Date- I M4 Ckent consoled_ El Yes Ci No F <br /> Summary of discussion <br /> 1 <br /> Corrective Acton (per PWC[terd) <br /> I <br />
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