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ARCHIVED REPORTS XR0000684
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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C
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CAPITOL
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6421
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2900 - Site Mitigation Program
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PR0522496
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ARCHIVED REPORTS XR0000684
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Entry Properties
Last modified
2/15/2019 10:31:29 PM
Creation date
2/15/2019 4:02:01 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0000684
RECORD_ID
PR0522496
PE
2957
FACILITY_ID
FA0015317
FACILITY_NAME
FLAG CITY CHEVRON
STREET_NUMBER
6421
STREET_NAME
CAPITOL
STREET_TYPE
AVE
City
LODI
Zip
95245
APN
05532024
CURRENT_STATUS
02
SITE_LOCATION
6421 CAPITOL AVE
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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11 <br /> . Brooks Rand LLC Sample Receiving Log <br /> Tracking# 02BR156 Due Date 515142 <br /> Recervmg Date 415102 <br /> Customer McCampbell Analytical Receiving Time 10 00 AM <br /> Contact Michelle Miller Logged-in by Frank McFarland <br /> Prolect Ref # MCA001 Login Date 4/5102 <br /> Collection Date 413!02 Login Time 12 00 PM <br /> QA Level Standard Airbill present? Yes <br /> Sample Condition Intact Airbill# 8256 4026 6873 <br /> Shipping container Intact? Yes Career FedEx <br /> Shipping container type cooler Custody seat present? Yes <br /> Shipping container temp 3 4°C Custody seal Intact? Yes <br /> Shipping container coolant ice COC Present? Yes <br /> GOC Number NIA <br /> Sample preservation 0 5%BrCI <br /> Acid lab# 02-074-BrCI Analysis request form? No <br /> Hg Concentration COC/Sample tag agree? Yes <br /> Sample storage area Cabinet#1 See SOW No See Project Manager No <br /> See Memo No See Lab Manager No <br /> Sample Turnaround Time Consult MSDS No See Contract Info No <br /> Contract Turnaround Time 30 days <br /> Comments <br /> I <br /> Lab 1D Sample Tag# Container# Size pH MatmdSub-Matrw Comments <br /> 1 Effluent glass 250 mL Bottle c2 Water,Effluent <br /> Analysis 1 Method Hg EPA 1631 Mod 2 <br /> — 2— Effluent(duplicate) glass 250 mL Bottle <2 —Water,Effluent —— —— <br /> Analysis I Method Hg EPA 1631 Mod 2 <br /> 3 <br /> —� �— -----g--- ---- -----__.._. -------.---- <br /> 3 EQ Blank lass--- 250 mL--Bottle c2 -- <br /> Water, <br /> Analysis 1 Method Hg EPA 1631 Mod 2 <br /> Sample Custodian sigrrature Date <br /> Page 1 of 1 <br />
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