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ARCHIVED REPORTS XR0004302
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3500 - Local Oversight Program
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PR0544686
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ARCHIVED REPORTS XR0004302
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Entry Properties
Last modified
7/23/2019 11:53:14 AM
Creation date
7/23/2019 11:24:27 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004302
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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I <br /> Chain of Custody Number <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento El Additional documents are attached,and are part of this Record <br /> Address 3017 Kilgore Road Suite 100 ,lob Name 7-Eleven Store#19976 <br /> Rancho Cordova CA Location 1399 North Main Street <br /> Manteca,California <br /> Project# 77E1_.19976.43 Task# 0410 Analysis Request <br /> Project Manager Jaff Auchterlonle <br /> Laboratory _ Kiff Analytical _ <br /> Turnaround Time Standard �' a � 2 <br /> Sampler's Name Brian Carey 3 <br /> Sampler's Signature ~ a I °° <br /> $ r = 1: � 9 6 a Comments/ <br /> Sample ID Date Time Matrix = w w m � i$ a w w Instructions <br /> G14 06/09/03 Soil X X X 1 <br /> SSG-' iZr <br /> rt3� � E3 <br /> I <br /> I <br /> Special Instruns/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 jauchterionis@secor com Print Brian Ca Print Chain of custody seals <br /> cc results to:dacatlin®secor com Company SECOR Compan Recd in good condition/cold <br /> 2a Tlm <br /> Time 1 _Date q a3 Date Conforms to record <br /> Relinquished by Received byf j.4 <br /> Sign Sign Irent SECOR <br /> Print Print Client Contact Jaff Auchterlonie <br /> Compa Compan Kiff Anal ical Client Phone 916 861-0430 <br /> T Date TimeDate 0 ext 223 <br /> 8£CORCUMECFw 7199 <br /> Date 5127/03 Page 1 of 1 <br />
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