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ARCHIVED REPORTS_XR0011998
Environmental Health - Public
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EHD Program Facility Records by Street Name
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W
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WILSON
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130
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3500 - Local Oversight Program
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PR0545892
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ARCHIVED REPORTS_XR0011998
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Last modified
7/22/2020 2:51:30 PM
Creation date
7/22/2020 2:38:13 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011998
RECORD_ID
PR0545892
PE
3528
FACILITY_ID
FA0003601
FACILITY_NAME
ARCO STATION #826951*
STREET_NUMBER
130
Direction
S
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205-5561
APN
15502064
CURRENT_STATUS
02
SITE_LOCATION
130 S WILSON WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIENT NAME: DATE Received at Lab, j a (Drinking water)for <br /> REC. BY(PRINT) TIME Received at Lab: regulatory purposes: IVVISINO <br /> WORKORDER, LOG IN DATE: (Wastewatcr)for <br /> regulatory purposes- YES/NO <br /> CIRCLE THE APPROPRIATE RESPONSE LAB SAMPLE DATE <br /> SAMPLE#I 9 CLIENT ED DESCRIPTION MATRIX SAMPLED CONDITION(ETC.) <br /> 1. Custody Seal(s) Vse,21 e t QYW.31AV42,Q4 VV <br /> ta I Broken* I LID <br /> 2. Chain-of-Cu,.Lo nt/Absent* <br /> 3. Traffic Reports or <br /> P2E1C11r List', Present <br /> 4. Airbill.- Airbill Sticker <br /> K <br /> Present <br /> 5. Aiibill,4: 1 -7 <br /> 6. Sam le Labels: "et 1 Absent <br /> 7, Sample IDs: ns, I Not Listed <br /> I <br /> on Chain-of-Custody <br /> M54yijz�Quo3 <br /> S. Sample Cundidun: no I/Broken*I <br /> Leaking* <br /> 9- Does h&niiation on <br /> custody reports,traffic <br /> reports and sample <br /> labels agree? �t No' <br /> 10. Sample received within <br /> hold tithe: s I No* <br /> 11, Proper Pmervatives <br /> used., ryI No* <br /> 12. Temp Rec- at Lab: <br /> (Acceptance range for samples T <br /> requiiing thermal res-W-2°C) No. <br /> *If Circled, enact Project Manager and attarl, re <br /> —=Orol resolution. <br /> Sample Receipt Log <br /> Revision 2.1 (1111 W00) Page of <br /> Replaces Revision 2(11/MOO) <br /> L Effective 1111 2iOL3 <br />
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