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REMOVAL_2002
EnvironmentalHealth
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2300 - Underground Storage Tank Program
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PR0231341
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REMOVAL_2002
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Entry Properties
Last modified
9/15/2021 1:20:11 PM
Creation date
11/8/2018 10:23:08 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
REMOVAL
FileName_PostFix
2002
RECORD_ID
PR0231341
PE
2361
FACILITY_ID
FA0003629
FACILITY_NAME
ARCO STATION #434*
STREET_NUMBER
501
Direction
W
STREET_NAME
KETTLEMAN
STREET_TYPE
LN
City
LODI
Zip
95240
APN
03119028
CURRENT_STATUS
02
SITE_LOCATION
501 W KETTLEMAN LN
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
Supplemental fields
FilePath
\MIGRATIONS3\K\KETTLEMAN\501\PR0231341\REMOVAL 2002.PDF
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EHD - Public
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SEQUOIA ANALYTICAL SA WLE RECEIPT LOG <br /> CLTTIlT1Ad�' _u DATER-eccivedAt Lab: l ��}—OZ <br /> REC.BY(I'Rl1 I) Drinkin water for <br /> ` TM- Received at Lab; 6 _ regalatoryPurposes: YES N <br /> WORKORDER: k?L LOG LN))ATE; /a Z� p z <br /> V4'astcRnter for <br /> a <br /> CIItLI E [ regulatory purposes: IES NO <br /> APPROPRIATE RESYO�TS> SAtti O'LE# >fLAB <br /> CONTAVER SAMPLE DATE RVYURIG; <br /> CLMNTID DESCRIPTION MATRIX SALWL,P,I;r CONDITION ,TC.) <br /> F. Custody SeaF(s) Presorteat l i Rye i <br /> Intact/Bro en 131 (l lzmEFa $ 1�'ZroL <br /> * �� <br /> ' 2. Cao n-0f Ctutod Pre-s /Absent* <br /> S.Traffic Reports or <br /> lacking List: Present/ bsen �113P <br /> 4.AL-ba- • Airbill/Sti &t <br /> pftsczit/KgCZ3- <br /> 5,Airbili ft: —� <br /> 6. Samol,Labeu., res Absent '{ ' .3 r(L, <br /> 7. S-%c IDs: Wort <br /> to <br /> cn'Chsin-of Custod <br /> 8. Sample Condition: 8rokm*! <br /> e <br /> 4. Doesiufotmeiionon <br /> t. Custody reports,traffic <br /> reports and sample <br /> labels agree? Y /NO*. <br /> 10. Sample reccived v ithin <br /> 6 hold <br /> 11. ProperPresrrntiv& <br /> used; <br /> 12, Temp Rec.at Lab: (a,0 <br /> p (Acceptancerange for sampl:s <br /> .quiring thermal p=.:4+/-2 No* -----------------. <br /> *If a rcled,contact Project:Manager and attach record of resolution. <br /> Sample Rooeipt Lag <br /> lslon 2.2(MM V02) <br /> laoes.Ravlslon 2.7 I?911LUp0) Page of <br /> .Ive 5!0 <br /> 04712 <br />
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