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INSTALL 2016 TANK TOP UPGRADE
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0231435
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INSTALL 2016 TANK TOP UPGRADE
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Entry Properties
Last modified
8/2/2019 3:32:32 PM
Creation date
8/2/2019 2:31:12 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
INSTALL
FileName_PostFix
2016 TANK TOP UPGRADE
RECORD_ID
PR0231435
PE
2361
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
01
SITE_LOCATION
1399 N MAIN ST
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
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KBlackwell
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EHD - Public
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TestAmerica West Sacramento <br /> 880 Riverside ParkwayChain of Custody Record `M `5r C,C <br /> West Sacramento,CA 95605 -- --�^ -- <br /> Phone 916 373-5600 <br /> Samp'a, lab PM Camer Tra"9 No(s). COC No: <br /> Client Information Brian Branscum Wagner.Heather <br /> Clsnt Contact. Phone' E-Mall Paye: <br /> Amanda Manse 916)281-8361 heather wa nar testamericainc.com Pae of <br /> Company: <br /> Job#. <br /> Stantec Consulting Services Inc. Analysis Requested <br /> Address Due Date Requested: Preservation Codes: <br /> 3875 Atherton Road $ <br /> city �i A_HCL M-Hexene <br /> Rocklin <br /> TAT Requested(days): 8-Na0H N-None <br /> Rocklin 24 HR W c-2n acetate O•A6Na02 <br /> Stele.Zip. D-Nitric Acid P-Na2O4S <br /> CA,95765 +r+ E-NBHSO4 p-Na2S03 <br /> Phone: pp# ¢ F-Ma0H R-Na2S2SC3 <br /> G-Amchlor S-H2SO4 <br /> 472-3985 z <br /> EmsIL H-Ascorbic Acid T-TSP Dodecahydrate <br /> Ercall: WO#: I-Ica U-Acetone <br /> 2m2;ea.. aCzae StanteC cc W0230335 ° <br /> 0 z a< m S J-DI Water v-MCAA <br /> ProJeet Name: Pmlea tt K-EDTA W_ph 4-5 <br /> Stenter-CA-non-ENFOS c W a a L-EDA 2-other(specify) <br /> e <br /> C1 LV <br /> 7-Eleven#19976 5sow# o m Other:O a <br /> N H d m A <br /> - - - Sampr-— efnz -Q -a e _ -- -- <br /> Type ( LL € m bi g 4 a a z' <br /> Sample (C-Comp oaomV o <br /> Sample DatTime G� rabe7-r .4- ,Sample identification <br /> o Special Instructions/Note: <br /> Preservation Code: <br /> S5- c?1 12/14/16 MILD G S X X X X X X X 1 <br /> "hve so,i <br /> �nl <br /> rM <br /> Z <br /> 00 <br /> D fit .M.� <br /> —I z <br /> rn <br /> z = <br /> D <br /> Possible Hazar rrtfflcstllonSa�mjle Disposal(A fee may be assessed if samples are retained longer than 1 month) <br /> Non-Hazardp Flammable n Irritant Poison B Unknown Radiological `-Retum To Client J Disposal By Lab Archive For Months <br /> Deliverable Requested:I,Ii,III,IV, ).II Special Instructions/0C Requirements: Email lab report to amanda magee@stantec.ccm, <br /> patnck.mcconnelt@stantec.com.deborah.lichtenberger@stanteccom;CmdxtZOCS�, fcom <br /> Empty Kit Relinquished by: Date: Time Me hm of Sh pmert. <br /> Re4ngw611e0 by. Osterrime- CompanyRe ed by. Date/Tma Company <br /> e <br /> 12114111, l i S 5 FRR►F� z 7 Z t Z vs —t11� <br /> Relinquished Dy: Daterrme Company Received by Delernme Company <br /> P > <br /> Reiinqushed by: Daterrime Company Received by ows'l-ime Company <br /> Custody Seals Intact- Custody Seal No.: Cower Tampersture(s;'C and Ctnar Remarks <br /> 3 Yes A No <br />
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