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Environmental Health - Public
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3500 - Local Oversight Program
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PR0545603
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Last modified
4/15/2020 4:31:58 PM
Creation date
4/15/2020 4:14:49 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545603
PE
3528
FACILITY_ID
FA0006095
FACILITY_NAME
PETERSON MFG
STREET_NUMBER
2403
STREET_NAME
NAVY
STREET_TYPE
DR
City
STOCKTON
Zip
95206
CURRENT_STATUS
02
SITE_LOCATION
2403 NAVY DR
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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Cal Aq & Enviro Lab Sample Receipt Checklist <br /> Client Name: Cardno ATC Date&Time Received: 04/10/15 17:00 <br /> Project Name: C&R International Client Project Number: Z054000010 <br /> Received By: DP Matrix: Water ❑ Soil E Sludge ❑ <br /> Sample Carrier: Client Laboratory ❑ Fed Ex ❑ UPS ❑ Other ❑ <br /> Argon Labs Project Number: R504010/1504100012 <br /> Shipper Container in good condition? Samples received in proper containers? Yes Q No ❑ <br /> NIA_ Yes ❑� No ❑ Samples received intact? Yes No ❑ <br /> Samples received under refrigeration? Yes No ❑ Sufficient sample volume for requested tests?Yes Q No ❑ <br /> Chain of custody present? Yes 0 No ❑ Samples received within holding time? Yes No ❑ <br /> Chain of Custody signed by all parties? Yes Q No ❑ Do samples contain proper preservative? <br /> N/A ❑ Yes No ❑ <br /> Chain of Custody matches all sample labels? Do VOA vials contain zero headspace? <br /> Yes Q No ❑ (None submitted Yes ❑ No ❑ <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted: Person Contacted: <br /> Contacted By: Subject: <br /> Comments: <br /> Action Taken: <br /> ADDITIONAL TEST(S)REQUEST I OTHER <br /> Contacted By: Dale: Time: <br /> Call Received By: <br /> Comments: <br /> r A <br />
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