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3500 - Local Oversight Program
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PR0544196
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Last modified
2/27/2019 3:18:43 PM
Creation date
2/27/2019 1:43:23 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0544196
PE
3528
FACILITY_ID
FA0006536
FACILITY_NAME
WELLS FARGO BANK PROPERTY
STREET_NUMBER
1034
STREET_NAME
CENTRAL
STREET_TYPE
AVE
City
TRACY
Zip
94805
APN
23517127
CURRENT_STATUS
02
SITE_LOCATION
1034 CENTRAL AVE
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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Q 660 Chesapeake Drive•Redwood City,CA 94063•(415)364-9600 . 0 18939 120th Ave.,N.E.,Suite 101 •Bothell,WA 98011 •(208)481-9200= - <br /> UNOCAL Q 819 Striker Ave.,Suite 8•Sacramento,CA 95834•(916)921-9600 0 East 11115 Montgomery,Suite B•Spokane,WA 99206•(509)924-9200 <br /> ❑ 1900 Bates Ave.,Sults LM•Concord,CA 94520•(510)686-9600 Q 15056 S.W.Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624-9800 <br /> y <br /> Company Name: Ge.�.�r- `R In Project Name:c. 0 <br /> Address: 3140 G o J 1 (ID"r- <br /> s rZd UNOCAL Project Manager: �\),c \Ce.r56 N <br /> City: Ra�✓cls (--ordove. Stale: � Zip Code: Release#: A m <br /> Telephone: 51- FAX#: 9t6 -G3 -13 I Site#: <br /> Report To: ��,� 1� Sampler: �a�i� �°5 <br /> QC Data: Level D(standard) ❑ Leve!C ❑ Level B ❑ Level A c <br /> Turnaround ❑ 10 Work Days U 5 Work Days ❑ 3 Work Days ❑ Drinking Water lAnalyses Requested <br /> Time: a2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water `� ru 0 Do <br /> CODE: LlMisc. ❑ Detect. ❑ Eval. ❑ Remed. ❑ Demol.❑ Closure C) Other p ��o <br /> Client DatefTime Matrix #of Cont. Laboratory � } (� �Q�� Comments <br /> Sample I.D. Sampled Dese. Cont. Type Sample# 1_ <br /> co ns l dc- 1d1" 0 <br /> 0 <br /> 0 <br /> 2. cc <br /> tpe 'darn Qr�`y5t5- <br /> 3. o <br /> 4 m <br /> 5. <br /> 6. <br /> 7. <br /> B. <br /> 9. <br /> 10. 1 . 1 1 ::Ll <br /> `o <br /> A' / <br /> [a <br /> Date: q 12!U k Time: 13 3a Received Date:f�'0/ Time: 13-� el �' <br /> Relinquished By: � <br /> i ..� J_ <br /> L .. Dater- z-�f Time (/�r Received BA Ate�l L}J,L.k-t Time: <br /> Relinquished By:l__ cam' <br /> . .Relinquished B`J Date: Time: Received B Lab: Date: Time: <br /> Page�—of <br /> Were Samples Received in Good Condition?b Yes Ch No Samples on Ice? Yes❑No Method of Shipment Pbl�a <br /> To be completed upon receipt of report: <br /> 1) Were the analyses requested on the Chain of Custody reported? Yes❑ Na If no,what analyses are still Heade -- --- <br /> 2) Was the report issued within the requested turnaround time? Q Yes❑ No If no, what was the turnaround time? — --- <br /> n.i pl oven hy. .. Signature: -----.:Company: --.-----'---------.-._.—._.-------- -.--- rn <br /> ate• <br />
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