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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0537923
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Last modified
2/13/2020 1:51:25 PM
Creation date
2/13/2020 11:19:48 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0537923
PE
2950
FACILITY_ID
FA0021891
FACILITY_NAME
DUFFY PROPERTY
STREET_NUMBER
375
Direction
W
STREET_NAME
LARCH
STREET_TYPE
RD
City
TRACY
Zip
95304
APN
21220010
CURRENT_STATUS
01
SITE_LOCATION
375 W LARCH RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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h 1534 willow Pass Road,Pittsburg CA 94565-1701 <br /> MCCampbell Analytical, Inc. Toll Free Telephone:(877)252-9262/F=(925)252-9269 <br /> ®� "When Quality Counts" bnp://www.mccarWbell.cm/E-mail:main@a nccampbell.com <br /> Sample Receipt Checklist <br /> Client Name: ERAS Environmental, Inc. Date and Time Received: 811612013 9:25:41 PM <br /> Project Name: #130150A; 375 West Larch Road Login Reviewed by: Zoraida Cortez <br /> WorkOrder N": 1308623 MatrixWater Carder: Beniamin Yslas(MAI Courier) <br /> Chain of Custody(COC)Information <br /> Chain of custody present? Yes W No❑ <br /> Chain of custody signed when relinquished and received? Yes W No❑ <br /> Chain of custody agrees with sample labels? Yes 0 No❑ <br /> Sample IDs noted by Client on COC? Yes 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 W <br /> Shipping container/cooler in good condition? Yes W No❑ <br /> Samples in proper containers/bottles? Yes W No❑ <br /> Sample containers intact? Yes © No❑ <br /> Sufficient sample volume for indicated test? Yes ka No❑ <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? Yes ka No❑ <br /> Container/Temp Blank temperature Cooler Temp: 4°C NA❑ <br /> Water-VOA vials have zero headspace/no bubbles? Yes © No❑ No VOA vials submitted ❑ <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 4 of 12 <br />
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