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ARCHIVED REPORTS XR0004297
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0544686
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ARCHIVED REPORTS XR0004297
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Entry Properties
Last modified
7/23/2019 11:44:00 AM
Creation date
7/23/2019 11:21:40 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004297
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 CustWy Number <br /> SECOR Chain-of Custody Record 395410 <br /> Field Office 477 Sacramento L3 Additional doamtents are aGached and are part of this Record <br /> Address 3097 Kilgore Road Suite 100 .lob Name 7-EWoon Store 019876 <br /> Rancho Cordova,CA_ Location 1399 North Main Street <br /> _........,.._. Manteca,Calffornia <br /> Project# TTEL19976 04 Task 9 0417 Analysis R uest <br /> Project Manager Jaff Auchterlonie <br /> Laboratory Ktff Anatyitcal _ <br /> Turnaround Time Standard 9 e <br /> Sampler's Name <br /> Samplers Signature i E <br /> ommenW <br /> Sample ID Date Time Matroc d Cstrucbons <br /> � $ �"� �� a,`�' w Insirtictfons � <br /> INF Air x x t <br /> EFF •-P ! r <br /> SpeaallnsbvctionsfComments Relinqu ' Rece Sample Receipt <br /> EDF global ID 70607700750 Sign Sign Total no of aontafrs <br /> ne <br /> Print ' f Pri Chain of oAdody seals <br /> EDF Deliverables-Email to dacatlin@seeor com Company a Company i? Redd m good conditlon/cold <br /> nt <br /> eail results to csanderslTi <br /> secor corn, me f Time r Date is �?3! Conforms to record <br /> uchterionie@secor com,tfinnIMsecor com Relinquis by Receiv jem o9 <br /> Sign Sign Client SECOR <br /> Print s Print Client Contact Casey Sanders <br /> Company co Company Client Phone (916}861-0400 <br /> Time / s Date oy TimeDate ext.291 <br /> Iscm aan=v—I <br /> Date Page <br /> I <br /> i <br />
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