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ARCHIVED REPORTS_XR0012733
Environmental Health - Public
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EHD Program Facility Records by Street Name
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18974
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3500 - Local Oversight Program
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PR0545721
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ARCHIVED REPORTS_XR0012733
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Entry Properties
Last modified
6/3/2020 11:42:51 AM
Creation date
6/3/2020 11:35:54 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012733
RECORD_ID
PR0545721
PE
3528
FACILITY_ID
FA0005425
FACILITY_NAME
LINDEN SHORT STOP
STREET_NUMBER
18974
STREET_NAME
MAIN
STREET_TYPE
ST
City
LINDEN
Zip
95236
CURRENT_STATUS
02
SITE_LOCATION
18974 MAIN ST
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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LSauers
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EHD - Public
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i 3 <br /> _ <br /> WESToN Analytics UsP Only Custody Transfer Record/Lab Work RequestAYA � _Iv <br /> ,5 Refri eratortl WESTON Analytics <br /> #!T a Container Use Only <br /> Client Samples Were: <br /> Work Order - Volume 1 Shipped or� � Data Due Z Hand- <br /> Date Recd.l0= ; 90 Preservative Delivered <br /> —�- � <br /> r' <br /> RFW Contact 8033 SEA _ NOTES:ANALYSES r,� <br /> Client ContacVPhone REQUESTED2 Ambient or Chilled <br /> NOTES: <br /> AUs ID Only <br /> ClientIDlDescription Matrix Dale Fb <br /> Collected B Received Broken/ i <br /> Q / to Lt 9D Leaking(Improperly <br /> Sealed) <br /> O Y N <br /> N <br /> NOYES: <br /> 4 Properly Preserved <br /> Y N <br /> NOTES: <br /> 5 Received Within <br /> Holding Times <br /> Y N <br /> NOTES: <br /> COC Tape Was: <br /> 1 Present on Outer <br /> Package Y N <br /> 2 Unbroken on Outer <br /> Package Y N <br /> 3 Present on Sample <br /> 1Ratrlr: W-Water DS-Drum Solids X-Other Special Instructions- _ p�, Y N <br /> S-Solt 0-011 DL-Drum Liquids Oddi_floN F1G i_AB FAr*e;iFS FI pua 4 Unbroken on Sample <br /> SE-Sediment A-Air F-Fish 4dd;t't'enr-oL XSQu6s T Tiv� AN,LLY,aS n P NOTES: Y N <br /> SO-Solid Wi-Wipe L- EPfrCIPLeachate 401✓6LE Lem- %I;.le/o <br /> IlemlReason Rellnguishadby Received bV DnM, Time ItemlReason Relinquished by Received by Date Time COC Record Was: <br /> t Present Upon receipt <br /> of Samples Y N <br /> Discrepancies Between <br /> Sample Labels and COC <br /> Record? Y N <br /> NOTES: <br /> RFW 21-21-00ljA-12/88 7.115 e� <br /> 9009-1005 <br /> �I <br /> �i <br /> 'I <br /> ' 1 <br />
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