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ARCHIVED REPORTS_XR0008737
Environmental Health - Public
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EHD Program Facility Records by Street Name
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W
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WATERLOO
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2537
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3500 - Local Oversight Program
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PR0545857
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ARCHIVED REPORTS_XR0008737
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Last modified
7/15/2020 4:52:02 PM
Creation date
7/15/2020 3:07:58 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0008737
RECORD_ID
PR0545857
PE
3528
FACILITY_ID
FA0005147
FACILITY_NAME
E-Z FOOD
STREET_NUMBER
2537
STREET_NAME
WATERLOO
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
11914035
CURRENT_STATUS
02
SITE_LOCATION
2537 WATERLOO RD
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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LSauers
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EHD - Public
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i Amon Laboratoripc Gam <br />le Receipt Checklist <br />Client Name A77-'- '45S�C %cr fes Date & Time Received 07/ / fo1 O / 6 9p <br />Protect Name iPPi6CS�,�or�n�r Ez -'r-J06`/46Client Protect Number 3-4 S8 <br />Received 9y Matrix <br />Water)/ Soil 1 <br />Sample Camer Client 1 aborato 1 FedEx 1 UPS 1 <br />Argon Labs Project Number ao 3 S t <br />Shipping Container 1 Cooler in good condition? <br />NIA Yes No <br />Samples received under refngerabon? <br />Yes No <br />Chain of Custody Present? Yes No <br />Chain of Custody signed by all parties? <br />Yes f No <br />Cham of Custody snatches all sample labels? <br />Yes / No <br />Date Client Contacted <br />Contacted by <br />Comments <br />IAction Taken <br />Samples received in proper contaArs? Yes No <br />Samples received intact? YesNo <br />Sufficient sample volume for requested tests? / <br />Yes// o <br />Samples received within holding time? Yes ✓ No <br />Do samples contain proper preservative? <br />NIA Yes No <br />Do VOA vials contain zero headspace? <br />(None submitted ) Yes '11 No <br />- - _ - <br />ANY "No" RESPONSE MUST SE DETAILED IN THE COMMENTS SECTION BELOW <br />Person Contacted <br />Subject <br />' Date Client Contacted Person Contacted <br />Comments <br />
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