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ARCHIVED REPORTS_XR0006641
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_XR0006641
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Entry Properties
Last modified
9/29/2020 10:21:30 PM
Creation date
8/5/2020 4:09:44 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006641
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
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EHD - Public
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w _ <br /> SPL HOUSTON ENVIRONMENTAL LABORATORY <br /> SAMPLE LOGIN CCRL T <br /> DATE: 25� p� TIME: /0 'Q9 CLIENT NO. <br /> LOT NO. CONTRACT NO. <br /> CLIENT SAMPLE NOS. <br /> SPL SAMPLE NOS. : r <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 aarbill/ ackin last/bi of lading with m <br /> P 9 1.1 g shipment? � <br /> If yes, ID# : IS-30131301 <br /> 4. Is a USEPA Traffic Report present? ✓ <br /> 5. Is a USEPA SAS Packing List present? ,T <br /> b. 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 at? <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 /> 9. Condition/temperature of shipping container: <br /> 118. Condition/temperature of sample bottles: 3 <br /> 11. � Sample Disposa SPL disposal Return to client <br /> L. � 1 1, 1 <br /> I NOTES (reference at m number if applicable) : <br /> i ! ' I t ! I I <br /> it i I <br /> I I L <br /> j <br /> ATTEST: ! d DATE: F� <br /> DELIVERED FOR R LUTI N: AbOD. DATE: <br /> RESOLVED: DATE.* <br />
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