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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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Chain of Custody Number <br /> SECOR Chain-of Custody Record z3rlb3 <br /> Field Office 077 Sacramento [3 Additional documents are attached,and are part of this Record <br /> Address 3017 Kilgore Road Sults 100 Job Name 7-Eleven Store 919976 <br /> Rancho Cordova CA Location 1399 North Main Street <br /> Manteca,Califtomia <br /> Project# 77EL19976.43 Task# 0410 Analysis Request <br /> Project Manager Jaff Auchterlonie <br /> Laboratory Kiff Anal cal ,o <br /> Turnaround Time Standard <br /> Samplers Name B n Care _ > m 0 <br /> 11 <br /> Samplers Signature N <br /> 13 <br /> _!2 = ? Comments/ <br /> Sample ID Date Time Matrix i CL 9m m a u Instructions z' <br /> IN 19/63 DUD soil X X 1 0 <br /> 1005 So' l7� <br /> I <br /> Special InstructlonslComments Relmgws, �y Recewed by Sample Receipt <br /> 5 Oxygenates,TAME,WEE,ELBE,TBA,s RIPE Sign It,KY Sign Total no of containers <br /> email results to jouchterlonle@secor.com Print Brian Carey Print Chain of custody seals <br /> cc results to dacatlin@secor.com Company SECOR Company Recd in good conditronlcold <br /> Time ] Za Date t Ti Date Conforms to record <br /> Relinquished by Received b I` <br /> Sign SignIf-WA Client SECOR <br /> Print Pant �. it Client Contact; Jaff Auchterlonie <br /> Com Company KiffAnalytical Client Phone (916)8614WWor#o p <br /> Date TiimeDate ext.223 <br /> see anrnEe w.a= <br /> Date 5127103 Page 1 of I <br /> i <br />
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