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ARCHIVED REPORTS XR0004295
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3500 - Local Oversight Program
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PR0544686
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ARCHIVED REPORTS XR0004295
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Entry Properties
Last modified
7/23/2019 11:50:07 AM
Creation date
7/23/2019 11:20:20 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004295
RECORD_ID
PR0544686
PE
3528
FACILITY_ID
FA0000916
FACILITY_NAME
7-ELEVEN INC #19976
STREET_NUMBER
1399
Direction
N
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
21633034
CURRENT_STATUS
02
SITE_LOCATION
1399 N MAIN ST
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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Chain of Custody Number <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento C) Additional documents are attached,and are part of this Record <br /> Address 3017 Kilgore Road,Suite 100 Job Name T-Eteven Store#19976 <br /> Rancho Cordova,CA Location 1399 North Main Street <br /> Mardeca,Callfomla <br /> Project# 77EL19976 04 Task# 0417 Anal Is Request <br /> Project Manager Jaff Auchterlonle <br /> Laboratory Kkff Ana!j�tcal <br /> Turnaround Time Standard <br /> X <br /> > <br /> Sampler's Name r4 <br /> ,Sampler's Signa CommenW <br /> Sample 10 Date Time Matrix 1� IWL Instructions <br /> INF -0 q( L&JO Air x x <br /> 1.5 D <br /> Special InstuctionslComments Relinqu d by Received by Sa pie Receipt <br /> EDF global ID T0607700750 Sign 1211 91ir Sign Total no of containers <br /> Pnnt lt"Pq AU,54. Print Chain of custody seals <br /> Co;p7a <br /> EOF Defiverables-Effiall to dacatlln@swor cam Company f2rd 'n>---- Reed in good condition/cold <br /> email results to ttinn@secor cam,jauchtarionte@secor cam Time in�) Date T5 Date Conforms to record <br /> Relinquished by Recelveq%&�h /V <br /> Sign Sign ClienL SECOR <br /> Print Print I Client Contact <br /> Compan Company Client Phone <br /> T, Date Time -0 <br /> 'SEWA CWTF=P-&W P <br /> Date Page <br />
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