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WORK PLANS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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JAHANT
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6540
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2900 - Site Mitigation Program
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PR0545317
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Entry Properties
Last modified
2/11/2020 10:51:04 AM
Creation date
2/11/2020 9:29:10 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
WORK PLANS
RECORD_ID
PR0545317
PE
2952
FACILITY_ID
FA0005251
FACILITY_NAME
M L GRENZ
STREET_NUMBER
6540
Direction
E
STREET_NAME
JAHANT
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
00526003
CURRENT_STATUS
02
SITE_LOCATION
6540 E JAHANT RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\sballwahn
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EHD - Public
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v <br /> CustodyTransfer Record/Lab Work Request <br /> I' WESTON Analytics Use Only M <br /> Refri erator# WESTON Analytics <br /> Use Only <br /> r' <br /> #/TypeContainer Samples Were: <br /> Client Volume 1 Shipped or Hand- <br /> Work Order r Preservative Delivered <br /> Date Recd. — ' r Date Due NOTES: <br /> RFW Contact ANALYSES <br /> Client Contact/Phone REQUESTED 2 Ambient or Chilled <br /> NOTES: <br /> Aeb Ifl ly Date <br /> Client IDIDescription Matrix Collected 3 Received Broken/ <br />! Leaking (Improperly <br /> Sealed) <br /> a Y N <br /> NOTES: <br /> 4 Properly Preserved <br /> Y N <br /> NOTES: <br /> 5 Received Within <br /> Holding Times <br /> Y N <br /> NOTES: <br /> t <br /> COC Tape Was: <br /> 1 Present on Outer <br /> Package Y N <br /> 2 Unbroken on Outer <br /> Package Y N <br /> i 9 Present on Sample <br /> Y N <br />{ Matrix. W-Water DS-Drum Solids X-Other Special Instructions: 4 Unbroken on Sample <br /> S-Soi! O-Oil DL-Drum Liquids <br /> SE-Sediment A-Air F-Fish NOT=S: Y N <br /> SO-Solid WI-Wipe L- EPITCLP Leachate <br /> ItemlReason Relinquished by Received by Date Time Item/Reason Relinquished by Received by Date Time COC Record Was: <br /> 1 Present Upon Receipt <br /> of Samples Y N <br /> Discrepancies Between <br /> i Sample Labels and COC <br /> Record? Y N <br /> NOTES: <br /> 7-115 <br /> RFW 21-21-0011A-12188 <br />
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