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ARCHIVED REPORTS_XR0011446
Environmental Health - Public
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EHD Program Facility Records by Street Name
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HARLAN
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16500
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3500 - Local Oversight Program
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PR0545275
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ARCHIVED REPORTS_XR0011446
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Entry Properties
Last modified
2/3/2020 3:35:58 PM
Creation date
2/3/2020 12:41:45 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011446
RECORD_ID
PR0545275
PE
3528
FACILITY_ID
FA0005678
FACILITY_NAME
LATHROP SHELL
STREET_NUMBER
16500
Direction
S
STREET_NAME
HARLAN
STREET_TYPE
RD
City
LATHROP
Zip
95330
CURRENT_STATUS
02
SITE_LOCATION
16500 S HARLAN RD
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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STL - <br /> STL San Francisco <br /> J Sample Receipt Checklist <br /> Submission #:2004- / <br /> Checklist completed by: (initials) ///K/ Date_ 1 e2-104 <br /> Courier name:�-J=San Francisco ❑ Client <br /> Not <br /> Custody seals intact on shipping eontainerlsamples Yes No Prese <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 <br /> Samples in proper container/bottle? Yes <br /> Sample containers intact? Yes .-�No <br /> Sufficient sample volume for indicated test? Yes�o <br /> Ali samples received within holding time? Yes <br /> Water-VOA vials have zero headspace? No VOA vials submitted Yes No <br /> (if bubble is present, refer to approximate bubble size and itemize in comments as S (small--O),M (medium O)or L(large-- 0) <br /> Water-pH acceptable upon receipt? ❑Yes ❑ No <br /> ❑ pH adjusted— Preservative used: ❑ HNO3❑ HCl ❑ H2SO4 ❑ NaOH ❑ZnOAc—Lot#(s) <br /> For any item check-listed "No", provided detail of discrepancy in comment section below: <br /> Comments: <br /> Project Management [Routing for instruction of indicated discrepancy(ies)] <br /> Project Manager: (initials) Date: 1 !04 Client contacted: ❑ Yes ❑ No <br /> Summary of discussion: <br /> Corrective Action (per PM/Client): <br />
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