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ARCHIVED REPORTS_XR0006640
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_XR0006640
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Entry Properties
Last modified
9/29/2020 10:20:47 PM
Creation date
8/5/2020 4:09:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006640
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
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LSauers
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EHD - Public
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SPL HOUSTON ENVIRONMENTAL LABORATORY <br /> SAMPLE LOGIN, CHECKLIST <br /> DATE: 123 TIME: Sr CLIENT NO. <br /> LOT NO. CONTRACT NO. <br /> CLIENT SAMPLE NOS. <br /> SPL SAMPLE NOS. : -f07 K <br /> YES NSC <br /> 1 . Is a Chain-of-Custody form present? <br /> 2. Is the COC properly completed? <br /> If no, describe what is incomplete: <br /> If no, has the client been contacted about it? <br /> (Attach subsequent documentation from client about the situation) <br /> • 3. Is airbill/packing list/ f 1 ding with shipment? <br /> If yes, ID#: <br /> 4. Is a USEPA Traffic Report present? <br /> 5. Is a USEPA SAS Packing List present? Tyr' <br /> 5. Are custody seals present on the package? <br /> If yes, were they intact upon receipt? <br /> 7. Are all samples tagged or labeled? ---� <br /> Do the sample tags/labels match the COC? �-- <br /> If no, has the client been contacted about it? <br /> (Attach subsequent documentation from client about the situation) <br /> 8. Do all shipping documents agree? <br /> If no, describe what is in nonconformity: <br /> ' I 1 <br /> 9. Condition/temperature of shipping container: <br /> 18. Condition/temperature of sample bottles: <br /> 11. Sample Disposal?: SPL dispos Retur to c lent <br /> ' NOTES (reference item number if applicable) : I <br /> !' 4 <br /> I <br /> I <br /> ATTEST: L ! DATE:' <br /> DELIVERED FOR R SOLUTIIO : REC'D DATE: <br /> RESOLVED: DATE: I' <br />
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