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Environmental Health - Public
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2900 - Site Mitigation Program
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PR0538738
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Last modified
2/6/2020 10:20:26 AM
Creation date
2/6/2020 9:20:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0538738
PE
2950
FACILITY_ID
FA0022243
FACILITY_NAME
NEIL O ANDERSON & ASSOC INC
STREET_NUMBER
902
STREET_NAME
INDUSTRIAL
STREET_TYPE
WAY
City
LODI
Zip
95240
CURRENT_STATUS
01
SITE_LOCATION
902 INDUSTRIAL WAY
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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h 1534 Willow Pecs Road,Pittsburg,CA 94565-1701 <br /> ® McCampbell Analytical, Inc• Toll Fme Telephone:(877)252-9262/Fu:(925)252-9269 <br /> "When Quality Counts" http:/Avww.mccampbeH.com/E-mail:main@m"mpbell.com <br /> Sample Receipt Checklist <br /> Client Name: Neil O.Anderson&Associates Date and Time Received: 4/112014 9:21:02 PM <br /> Project Name: #LZ140001;NOA Drynell, Lodi,CA Login Reviewed by: Ana Venegas <br /> WorkOrder N": 1404047 Matrix: SoilNJater Carrier: Brian STANFORD(MAI Courier) <br /> Chain of Custody(CDC)Information <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 d❑ No❑ <br /> Sample IDs noted by Client on COC? Yes 0 No❑ <br /> Date and Time of collection noted by Client on COC? Yes No❑ <br /> Sampler's name noted on COC? Yes ❑✓ No❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA 91 <br /> Shipping container/cooler in good condition? Yes No❑ <br /> Samples in proper contamers/bottles? Yes ❑ No❑ <br /> Sample containers intact? Yes No❑ <br /> Sufficient sample volume for indicated test? Yes © No❑ <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? Yes W No❑ <br /> Containerlremp Blank temperature Cooler Temp: 1.1°C NA❑ <br /> Water-VOA vials have zero headspace/no bubbles? Yes © No❑ NA❑ <br /> Sample labels checked for correct preservation? Yes ❑.I No❑ <br /> Metal-pH acceptable upon receipt(pH<2)? Yes ❑ No❑ NA <br /> Samples Received on Ice? Yes ❑ No❑ <br /> (Ice Type: WET ICE ) <br /> *NOTE:if the"No"box is checked,see comments below. <br /> --------------------------------------------- <br /> Comments: <br /> Page 78 of 78 <br />
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