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ARCHIVED REPORTS XR0001167
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0527799
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ARCHIVED REPORTS XR0001167
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Entry Properties
Last modified
3/4/2019 6:31:35 PM
Creation date
3/4/2019 1:35:08 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0001167
RECORD_ID
PR0527799
PE
2960
FACILITY_ID
FA0018844
FACILITY_NAME
TRANSMISSION STORE
STREET_NUMBER
515
Direction
W
STREET_NAME
CHARTER
STREET_TYPE
WAY
City
STOCKTON
Zip
95206
APN
14707408
CURRENT_STATUS
01
SITE_LOCATION
515 W CHARTER WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
WNg
Tags
EHD - Public
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s +� M d"WrFCfflFOD Y"AE"S MUEMST F(Z <br /> SHAW En&+rental&Infrastructure,Inc. Purchase Order- lA <br /> 1326 North Matlurt Radius Sacra+meatu CA 95834 Lab STL I Quauterra,W.Sacto <br /> Project Name Dan Rogers Anal is Requested <br /> Project Number 8800391A/01020900 <br /> Protect Manager David Herzog N <br /> Company SHAW Enwoomental&Infrastructure,Inc. 00 <br /> Address 1326 North Market Boulevard <br /> 0 <br /> Sacramento,CA 95834 v °O <br /> Phone 916-56543771 FAX 16-565-4356 w rxrl <br /> L <br /> Sampler's Signature `r t <br /> REMARKS <br /> Sample LAB Sample I Container Types <br /> ID ate Tune ID MatnxTedlaz Preservations <br /> INFL / Sala S V r I 1 <br /> EFFL a Va r 1 1 <br /> O <br /> O <br /> O <br /> O <br /> O <br /> W <br /> REL HED BY 0 RECEIVED BY RELINQUISHED BY RECEIVED BY TURNAROUND REPORT REQUIREMENTS <br /> REQUIREMENTS X I Routine Report <br /> Signature S14P=tNarne <br /> 2418 4e hr 5 day II Report(includes DUP,MS <br /> —� X Stendard(-10.15 working days) MSD,as required,may be <br /> ted ame Printed Name d Name 1V Provide verbal Prehmmary Results charged as samples) <br /> Tum R Wright 4ft Kn $l Provide FAX Prehmtnsry Results III Data Validation Report <br /> Firm Firm Firm Finn Requested Report Date (includes All Raw Data) <br /> Shaw E&I Inc, L RWQCB <br /> Date/Time aldy T6 DatelTime Date me / DaJw T1me ) (MDLs/PQLVTRACI#) <br /> REL DISHED BY REC'EtV1tD BY Special Ins uc ns/Comments Container Types Key <br /> 40 ml VOA i <br /> Signature Signature STL/Quanterra 125 ml LPE 2 <br /> 880 Riverside Parkway 500 mi LPE 3 <br /> Printed Name Panted Name West Sacto,Calif I liter HDPE 4 <br /> 4I6-373-5600 500 ml glass 5 <br /> I•irin Firm Jon Gildersleeve I liter glass 6 <br /> 2x6 s/s ring 7 <br /> DatelTime DatelTime _ glasslar 8 <br />
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