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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 <br /> umberSECOR Chain-of Custody Record <br /> Field Office 077 Sacramento 0 Additional documents are attached, and are part of this Record <br /> Address 3017 IG[gore Road,Suite 100 Job Name 7-Eleven Store#19976 <br /> Rancho Cordova,CA Location 1399 North Main Street <br /> Manteca,Califomla <br /> Project# 77EL 19976.43 Task# 0410 Analysis Request <br /> Project Manager Jaff Auchterlonle <br /> 0 <br /> Laboratory Kiff Analytical `° <br /> Turnaround Time Standard a ;, _ m <br /> w <br /> r- CLm is e m � <br /> Samplers Name Brian Care n <br /> Sample's Signature ; " , m `� o `� H <br /> Q _ 2 m °D m °� o °6 Comments/ n <br /> E <br /> �n <br /> Sample ID Date Time Matnx = a a a o o n o m ( a Instructions z <br /> p � f- m f d �n � mzmwmv, w <br /> N- ( l9 63 Oqso Sod X x 1 p 1 <br /> ZN- f3` '-1(9 03 I oct; So i <br /> Speaal Instructions/Coinments Relinquis d�y Received by Sample Receipt <br /> 5 Oxygenates-TAME, MtBE, ELBE,TBA,&DIPE Sign - - Sign Total no of containers <br /> email results to lauchterionie@secor com Pnnt Bnan Carey Pnnt Chain of custody seals <br /> cc results to dacatlin@secor com Company SECOR Company Recd in good condition/cold <br /> Time 1 Zp Date t 4 Ti Date Conforms to record <br /> Relinquished by Received b F <br /> Sign Sign - <br /> Client SECOR <br /> Pnnt Pnnt Lam- i� Client Contact Jaff Auchterlonie <br /> Comp Company Kill Anai ical Client Phone (916)8614MM04 0 <br /> e Date Time �SDate_DA,,ap ext 223 <br /> SECOR c PAV <br /> Date 5127103 Page 1 of i <br />
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