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ARCHIVED REPORTS_XR0006480
Environmental Health - Public
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EHD Program Facility Records by Street Name
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Y
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YOSEMITE
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1012
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3500 - Local Oversight Program
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PR0545948
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ARCHIVED REPORTS_XR0006480
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Entry Properties
Last modified
9/29/2020 10:16:59 PM
Creation date
8/5/2020 3:51:39 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006480
RECORD_ID
PR0545948
PE
3528
FACILITY_ID
FA0005159
FACILITY_NAME
FILL-EM FAST
STREET_NUMBER
1012
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
21903024
CURRENT_STATUS
02
SITE_LOCATION
1012 W YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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Amon Laboratories Sam le Receipt Checklist <br /> iClient Name -A Date&Time Received %6 ! 3C ! e /to SIC <br /> Protect Name R S E -E v& Client Protect Number Q S Q-7 �3S1C1 <br /> Received By Matrix ate I Soil ! <br /> Sample Camer Client 1 ra o FedEx I UPS I <br /> ' Argon Labs Protect Number <br /> Shipping Container I Cooler in good condtion? Samples received in proper containers? Yes Y- No <br /> i4 <br /> N/A—X-_Yes No Samples received intact? Yes x No <br /> Samples received under refngerabon? Sufficient sample volume for requested tests? <br /> Yes X No Yeses_ No <br /> iChain of Custody Present? Yes >'-' No Samples received vAthin holding time? Yeses No <br /> Chain of Custody signed by all parties? Do samples contain proper preservative? <br /> ' Yes.__y No NIA Yes [ No <br /> Chain of Custody matches all sample labels'? Do VOA vials contain zero headspace? <br /> iYes 'X No (None submitted}Yes X No <br /> ANY"No"RESPONSE MUST BE DETAILED IN THE COMMENTS SECTION BELOW <br /> Date Client Contacted Person Contacted <br /> iContacted by Subject <br /> Comments <br /> i. <br /> Action Taken <br /> 1 <br /> 1� E <br /> OTHER <br /> iDate Client Contacted Person Contacted <br /> Comments <br /> i <br /> i <br /> € <br /> E <br />
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