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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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PR0537795
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Last modified
5/28/2020 4:31:07 PM
Creation date
5/28/2020 4:28:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0537795
PE
2950
FACILITY_ID
FA0021799
FACILITY_NAME
SHELL GAS STATION/ANABI OIL
STREET_NUMBER
3725
STREET_NAME
TRACY
STREET_TYPE
BLVD
City
TRACY
Zip
95304
APN
21217030
CURRENT_STATUS
01
SITE_LOCATION
3725 TRACY BLVD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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1534 Willow Pass Road,Pimburg,CA 94565-1701 <br /> ® McCamobell Analytical, Inc. Toll Free Telephone:(877)252-9262/Fax:(925)252-9269 <br /> "When Quality Counts" http://www.mcc=pbell.com/E-mail:main@mn mpbell.com <br /> Sample Receipt Checklist <br /> Client Name: AEI Consultants Dale and Time Received: 6/19/2013 4:49:46 PM <br /> Project Name: #319400;Anabi(Tracy) Login Reviewed by: Zoraida Cortez <br /> WorkOrder N°: 1306491 Matrix: SoilNWater Carrier: Client Drop-In <br /> Chain of Custody ICOCI 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 © No❑ <br /> Sample IDs noted by Client on COC? Yes © No❑ <br /> Date and Time of collection noted by Client on COC? Yes W No❑ <br /> Sampler's name noted on COC? Yes W No❑ <br /> Sample Receipt Information <br /> Custody seals intact on shipping container/cooler? Yes ❑ No❑ NA <br /> Shipping container/cooler in good condition? Yes W No❑ <br /> Samples in proper contamers/bottles? Yes © No❑ <br /> Sample containers intact? Yes ® No❑ <br /> Sufficient sample volume for indicated lest? Yes © No❑ <br /> Sample Preservation and Hold Time(HT)Information <br /> All samples received within holding time? Yes J❑ No❑ <br /> Container/Temp Blank temperature Cooler Temp: 19°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 ❑Q No❑ <br /> Metal-pH acceptable upon receipt(pH<2)? Yes ❑ No❑ NAW <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 /> --------------------------------------------- <br /> Comments: <br /> Page 5 of I 1 <br />
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