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ARCHIVED REPORTS XR0003313
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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D
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DA VINCI
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4627
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2900 - Site Mitigation Program
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PR0543804
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ARCHIVED REPORTS XR0003313
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Entry Properties
Last modified
6/28/2019 4:06:28 PM
Creation date
6/28/2019 1:56:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003313
RECORD_ID
PR0543804
PE
2950
FACILITY_ID
FA0024907
FACILITY_NAME
7-ELEVEN STORE #20632
STREET_NUMBER
4627
STREET_NAME
DA VINCI
STREET_TYPE
DR
City
STOCKTON
Zip
95207
CURRENT_STATUS
01
SITE_LOCATION
4627 DA VINCI DR
P_LOCATION
01
QC Status
Approved
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Tags
EHD - Public
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0 Chain of Custody Number '�5915'5 0 <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento D Additional documents are attached,and are part of this Record <br /> Address 3017 Kilgore Road,Suite 100 Job Name 7-Eleven Store#20632 <br /> Rancho Cordova,CA Locabon 4627 Da Vinci Drive <br /> Stockton,California <br /> Project# 77EL.20632 03 Task# 0410 allysis Request <br /> Project Manager Jaff Auchterlonie <br /> Laboratory Kiff Analytical m g <br /> Turnaround Time StandardN <br /> 3 �'N <br /> � $ .18 O w C <br /> W <br /> M � <br /> Sampler's Name //r _ <br /> Sampler's Signature m E " e n <br /> = x = 19 .9 <br /> 2g, Comments) e <br /> Sample ID Date Time Matrix z >m =m r� io ° W I Instructions x <br /> MW-1 91.a /a Ys` Water x X X d( 3 <br /> MW-2 -p-oy /36o Water x X X 3 <br /> MW-3 7-r ► Water x X X 03 3 <br /> MW-4R - II- 3 Water x X X 611 3 <br /> MWS .>7 0 30 Water x X X C 3 <br /> -� MW-6 - .6 /000 Water x X X dlo 3 <br /> MW-7 7- --Y /t13e Water x X X v� 3 <br /> Special Instructions/Comments Relinquished b Received by Sample Receipt <br /> 5 Oxygenates TAME,MtBE,EtBE,TBA,i4 DIPE Sign Sign Total no of containers <br /> Global ID 970607700798(SIRC) Print a... -Punt Chain of custody seals <br /> email EDD to dacatlin@secor com Company ,,� Compan Recd in good oondit on/cold <br /> email results to dherzog@secor com and Time Date Time Date Conforms to record <br /> bcarey@secor com Relinquished by- Received by, <br /> Sign Sign /`J Client SECOR <br /> Print Print fin! Client Contact Brian Care <br /> Compan Company 6,5 e rr' Client Phone 916 861-WO <br /> Tim Date Time 1S5U Date or7getou., ext 241 <br /> SEWRCUSTRECRM 2= <br /> Date 7 ,e-oz Page b <br />
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