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3500 - Local Oversight Program
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PR0544583
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Last modified
6/19/2019 10:15:59 AM
Creation date
6/19/2019 10:01:57 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0544583
PE
3528
FACILITY_ID
FA0003643
FACILITY_NAME
CHEM-AWAY, INC
STREET_NUMBER
30600
Direction
S
STREET_NAME
CORRAL HOLLOW
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
25310015
CURRENT_STATUS
02
SITE_LOCATION
30600 S CORRAL HOLLOW RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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GeoAnalytical Laboratories, Inc. Lab Report 0 Rig <br /> Regulatory ❑No CQ Wes -0 No • <br /> 1405 Kansas Avenue, Suite"A" Phone: (209)572-0900 d.0- <br /> Modesto,CA 95351 Fax: (209)572-0916 Regulator. Le s- A/ <br /> Phone: (.Df) <br /> Client: ... 9gi G D CHAIN OF CUSTODY Fax: W ) <br /> Address: S . -77-jk Sf Original To: ep i� saJ <br /> City Zip 2 35- <br /> Project ID 9 7- '� b y Lab use Only <br /> (Print Name) ':j <br /> K�3 <br /> Sampled BY Cft .�/ •� <br /> (Signature) Container <br /> e / 4V <br /> Date Tune Sample <br /> tYPe Sample ID <br /> crab comp M2 Type Sime <br /> Remarks r, <br /> Relinquished by.(Signature) Date Time, Received by(Signature) Dau Time <br /> /2-ZY-DD 'S7� .-t7 =TZ /2 Zroo <br /> Relinquished by(Sipaau-) Date Time Received by(Sigoau-) Date Time <br /> Presenwdve Matrix <br /> 0-400 ®-HCL 0-NaOH e-NazSgO, $-HNO, .O-H2 S 04 ®-Other ®Drinking Water®NVaste Water 4WHazardous Waste(Water) OSoi Wid <br /> i <br /> Site Time: / Drivin me: Ti�/ Mile�e <br /> —�O <br /> Start 3 0 Fmish: f Total Haus: 2 Start: $Ti /Z-0 R rrival: /SV /xTt otal: Z <br /> M-W-und Time OSilver Rush OGWd Rush OPlatinum Rush DOd. Approved By: <br />
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