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ARCHIVED REPORTS XR0004310
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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1399
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3500 - Local Oversight Program
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PR0544686
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ARCHIVED REPORTS XR0004310
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Entry Properties
Last modified
7/23/2019 11:42:13 AM
Creation date
7/23/2019 11:27:50 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004310
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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SJGOV\wng
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EHD - Public
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STL - LOS ANGELES R� ` <br /> PROJECT RECEIPT CHECKLIST Date• <br /> Quantims Lot # lG �' �' Quote # <br /> Client Name r- Project � � E c1't3�-C'�-� �- <br /> Received by Date/Time Received 1— I �—�� 64- /�'6 TD <br /> Delivered by ❑Client []Airborne [BFed Ex ❑DHL ❑Ultra-Ex -❑Rey B <br /> ❑UPS []DES ❑Other <br /> Initial / Date <br /> I <br /> elf- <br /> Custody Seal Status ffintact ❑Broken ❑None .��__H �t <br /> --QNo Seal # i <br /> Custody Seal #(s) <br /> Sample Container(s) ❑STL-LA [✓Client []N/A --LL <br /> Temperature(s) (COOLEMLANlq in OC' �CORREDTED TEMP) <br /> Thermometer Used (ZIR (Infra-red) ❑Digital (Probe) <br /> Samples [intact ❑Broken []Other <br /> Anomalies ❑Na [:]Yes (See Clouseau) •• - •- <br /> Labeled by . . .. . .. . <br /> Labeling checked by .. ••• •• ' <br /> •.....,•...,.•s•w........a.....,•a•.....aa.a....a,a..............s.,....a..........„w..••„w...a►a w..a..a• <br /> Turn Around Time []RUSH-24HR ❑RUSH-48HR ❑RUSH-72HR [3fJORMAL <br /> Short-Hold Notification. []Ph []Wet Chem ❑Metals (Filter/Pres) ❑Encore []N/A <br /> Outside Analysis(es) (Test/Lab/Date Sent Out) �' « <br /> •••••••••• LEAVE NO BLANK SPACES USE N1 ••'•""•• <br /> PFj <br /> Fraction IA <br /> VOAh /* 3 <br /> aeaZm AanmSt�mm Hy&azpdc ii25W OLHNO3 a0PHId03-raid fihcmd dtll FQW3 iib Ciloeed <br /> h HCI salnm H de Back EE==Saaples V VOA <br /> CGl C[eu Gun Sar C'Ge Clem Gina&X* ACAkAmba GIM 1w AGH Amba Glm Bon1e !6 !dr <br /> * Number of VOA's w/Headspace present <br /> REVIEWED BY/BATE: <br /> LOGGED BYIDATE � <br /> 900003 <br />
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