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REMOVAL_2024
Environmental Health - Public
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EHD Program Facility Records by Street Name
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M
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MOORE
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15271
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2300 - Underground Storage Tank Program
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PR2500441
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REMOVAL_2024
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Entry Properties
Last modified
8/22/2025 4:15:22 PM
Creation date
8/22/2025 4:06:29 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
REMOVAL
FileName_PostFix
2024
RECORD_ID
PR2500441
PE
2361 - UST FACILITY
FACILITY_ID
FA0004223
FACILITY_NAME
UMAIR KHAN
STREET_NUMBER
15271
STREET_NAME
MOORE
STREET_TYPE
RD
City
LODI
Zip
95242
CURRENT_STATUS
Inactive
QC Status
Approved
Scanner
SJGOV\kblackwell
Supplemental fields
Site Address
15271 N MOORE RD LODI 95242
Tags
EHD - Public
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Sample Receipt Checklist <br />McCampbell Analytical, Inc.1534 Willow Pass Road, Pittsburg, CA 94565-1701 <br />Toll Free Telephone: (877) 252-9262 / Fax: (925) 252-9269 <br />http://www.mccampbell.com / E-mail: main@mccampbell.com"When Quality Counts" <br />Client Name:ACTEnviro <br />WorkOrder №:2407453 <br />Date Logged:7/9/2024 <br />Logged by:Agustina VenegasMatrix:Soil <br />Carrier:Client Drop-In <br />Shipping container/cooler in good condition?Yes No <br />Custody seals intact on shipping container/cooler?Yes No NA <br />Samples Received on Ice?Yes No <br />Chain of custody present?Yes No <br />Chain of custody signed when relinquished and received?Yes No <br />Chain of custody agrees with sample labels?Yes No <br />Samples in proper containers/bottles?Yes No <br />Sample containers intact?Yes No <br />Sufficient sample volume for indicated test?Yes No <br />NAAll samples received within holding time?Yes No <br />NASample/Temp Blank temperature <br />Yes No NAZHS conditional analyses: VOA meets zero headspace <br />requirement (VOCs, TPHg/BTEX, RSK)? <br />pH acceptable upon receipt (Metal: <2; Nitrate 353.2/4500NO3: <br /><2; 522: <4; 218.7: >8)? <br />Yes No NA <br />Temp:6.9°C <br />Chain of Custody (COC) Information <br />Yes NoSample IDs noted by Client on COC? <br />Yes NoDate and Time of collection noted by Client on COC? <br />Yes NoSampler's name noted on COC? <br />Sample Receipt Information <br />Sample Preservation and Hold Time (HT) Information <br />Sample labels checked for correct preservation?Yes No <br />Project:Ukhan-524425; Khan Property <br />(Ice Type:BLUE ICE ) <br />Comments: <br />pH tested and acceptable upon receipt (200.7: ≤2; 533: 6 - 8; <br />537.1: 6 - 8)? <br />Yes No NA <br />UCMR Samples: <br />Free Chlorine tested and acceptable upon receipt (<0.1mg/L) <br />[not applicable to 200.7]? <br />Yes No NA <br />Date and Time Received:7/9/2024 11:08 <br />Received by:Agustina Venegas <br />COC agrees with Quote?Yes No NA <br />Custody seals intact on sample bottles?Yes No NA <br />Page 32 of 32
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