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ARCHIVED REPORTS_XR0003624
Environmental Health - Public
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EHD Program Facility Records by Street Name
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K
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KETTLEMAN
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420
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3500 - Local Oversight Program
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PR0545336
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ARCHIVED REPORTS_XR0003624
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Entry Properties
Last modified
2/10/2020 4:46:25 PM
Creation date
2/10/2020 4:11:51 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003624
RECORD_ID
PR0545336
PE
3528
FACILITY_ID
FA0003776
FACILITY_NAME
KWIK SERV LODI BW 113*
STREET_NUMBER
420
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
06202042
CURRENT_STATUS
02
SITE_LOCATION
420 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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e <br /> . y <br /> COOLER RECEIPT FORM <br /> ect: Log No- (%3t <br /> er receive on: and checkea on JWCWAG= �9 <br /> Signa e <br /> e custody papers present ). . . . . . . . . . . . . . . . . . . . . . . . . . . . . 'YES NO <br /> e custody papers properly filled out". . . . . . . . . . . . . . . . . . . 10 NO <br /> e the custody papers signed) . . . . . . . . . . . . . . . . . . . . . . . . . . IYESNO <br /> sufficient zee used? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NO <br /> all bottles arrive in good condition (unbroken) ? . . . . . . NO <br /> bottle labels match COC? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . NO <br /> e proper bottles used for analysis indicated?. . . . . . . . . . NO <br /> rect preservatives used?. . . . . . . . . . . . . . . . . . . . . NO <br /> vials checked for headspace bubbles'' . . . . . . . . . . NO <br /> Note which voas (if any) had bubbles: * <br /> ple descriptor: Number of vials: <br /> VOAs with headspace bubbles have been set aside so they will not be <br /> I for analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . YES NO <br /> here all other fobs received in the same cooler: <br /> t Job # NET log # <br /> (coolerrec) <br />
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