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ARCHIVED REPORTS XR0003398
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 XR0003398
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Entry Properties
Last modified
6/28/2019 3:42:57 PM
Creation date
6/28/2019 2:42:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003398
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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SJGOV\wng
Tags
EHD - Public
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Acculabs IncF. Lab Number <br /> _1 1046 Olive Dnve Davis CA 95616 530-757-0920 Fax 753-6091 <br /> ( <br /> 175 Suttle St Durango CO 81301 970-247-4220 Fax 247-4227 Report <br /> [ <br /> 14663 Table Mountain Dr Golden CO 80403 303-277-9514 Fax 277-9512 Due Date <br /> { <br /> 1992 Spice Islands Dr Sparks NV 89431 775-355-0202 Fax 355-0817 <br /> Client Fax Results Y N Page of <br /> Address PUBLIC WA ERS #PLY NFORMATION fiW _; <br /> City,State&ZiR(, ��U System Name <br /> Contact / PWS No Report to State/EPA Y N <br /> PhG S Collector's Nam <br />' i POE No DWR No <br /> F S —0 Project Nam ( t AZan3�2 Collection Point <br /> P O Number Project Number ) City County <br /> SAMPLE PEiCODES <br /> ,S xr Analyses <br /> C <br /> DW=drinking water TB=travel blank Compliance a 0 Requeste <br /> WW=waste water SD=solid Monitoring P <br /> MW= onitonng well SO=soil <br /> Y N e i <br /> =hazardous waste SL=sludge <br /> ' RNAROUNDYIIIAE"REQUESTED,,- q' �T� e <br /> Standard Lab Manager y r <br /> Approval p} s ` <br /> u` <br /> Special k e r <br /> C IENTS,SAMP,LE IDlLOCATION, '�, Date' ;-Time_` °z Spl No <br /> 1 <br /> 1 <br /> a <br />' Instructions/Comments/Special Requirements <br /> S^ .4 tt ♦ Y I <br /> ;AMPLr RECEIPT ` Date Time ' gSary Ales"Relinq'uisl�ed By Samples Received By <br /> Received Cold Y N tt 7 i, t;fG <br /> Custody Seals Y N <br /> Seals Intact Y N <br /> o of Containers <br /> -^ <br /> Acculabs,"Inc's Standard Terms and Conditions apply unless written agreements specify otherwise Payment terms are Net 30 <br /> To the maximum extent permitted by law,the Client agrees to limit the liability of Acculabs Inc for the Client's damages to the total compensation <br /> received unless other arrangements are made in writing This limitation shall apply regardless of the cause of action or legal theory pled or asserted <br /> 301 2 <br />
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