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ARCHIVED REPORTS XR0003318
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 XR0003318
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Entry Properties
Last modified
6/28/2019 3:57:14 PM
Creation date
6/28/2019 2:04:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003318
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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EHD - Public
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Cham of Custody Number _ <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento EJ 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 Location 4627 Da Vinci Drive <br /> Stockton,California <br /> Project# 77EL.20632 43 Task# 0410 Analysis Request <br /> Project Manager Jaff Auchterlonie O <br /> Laboratory Kiff Analytical <br /> Turnaround Time Standard _ a �5' °' 1'4 <br /> G 4 C C7 �{ G <br /> dm is YSV > OV ra <br /> Sampler's Name Danielle Catlin-Wrl ht <br /> Sampler's Signature o r <br /> c � <br /> r' �, tM o <br /> m n v m - °'m > m P m Comments/ <br /> U a n=. o R o occu � o mc"v 00. �. E <br /> Sample ID Date Time Mafix z +- m a (0 > � CO m Ln w Instructions z' <br /> •�f 04/04/03 Q'/ Soil X X f <br /> L <br /> Special Instructions/Comments Relinquished by Received by Sample Receipt <br /> 5 Oxygenates,TAME, MtBE, EtBE,TBA, &DIPE Sign -Sign Total no of containers <br /> email results to jauchterlonle@secor corn Printrant Chain of custody seals <br /> Company Company Recd in good condition/cold <br /> Time ; Date oy Time Date Conforms to record <br /> Relinquished by Recei by <br /> Sign Sign Client SECOR <br /> Print Print aH{v Client Contact Jaff Auchterlonie <br /> Compa Company l F NAL7TVCkent Phone 916 861-0430 <br /> SECOR CUSTMr,FkV 2M Date Time LO SO Date 040705 ext.241 1 <br /> Date D'y - 6'Y-03 page f06 <br /> I <br />
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