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ARCHIVED REPORTS_XR0007177
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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E
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88 (STATE ROUTE 88)
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14000
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3500 - Local Oversight Program
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PR0544811
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ARCHIVED REPORTS_XR0007177
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Entry Properties
Last modified
11/20/2024 9:21:19 AM
Creation date
9/5/2019 1:48:47 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007177
RECORD_ID
PR0544811
PE
3528
FACILITY_ID
FA0000091
FACILITY_NAME
Colonial Energy CE 40138 (DBA Power Mart)
STREET_NUMBER
14000
Direction
E
STREET_NAME
STATE ROUTE 88
City
LOCKEFORD
Zip
95237
CURRENT_STATUS
02
SITE_LOCATION
14000 E HWY 88
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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Tags
EHD - Public
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• i o � <br /> Chain of Custody Number <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento VU8 11112 &Y) 4 D5 LJ Additional documents are attached, and are part of this Record <br /> Address 3017 Kilgore Road,Suite 100 Job Name Time Oil <br /> Rancho Cordova,CA 95670 Location 14000 East Highway 88 <br /> Lockford,CA <br /> Project# 770T 41737 00 Task# 0004 Analysis Request <br /> Project Manager Todd Brown m <br /> Laboratory ExelChem % 2 0 to e <br /> Turnaround Time Standard ro CO <br /> T uF°,° a a <br /> Samplers Name Ben Wright o o d m m W, o <br /> n <br /> Sampler's Signature Co� K m L y � a <br /> o x m ., m m Comments/ e <br /> Sample ID Date Time Matrix = o m w a u°, instructions z <br /> I)IDI/04 1-605 o L41 i I 1 0 2 kLh Udif forRer <br /> 5 - @i ro 2 <br /> 56-t2 z I 15- Q <br /> 5 -tZ- °� zo k3Zl04 11110 2_ 51 -11 21 40L.0 <br /> 51..tz t4 Ili 1012 15 - 11 3 <br /> %3- 12 @.'St) 133 N XLi I 110 2 5 - 1 4- <br /> -17- 36 ►mss k 01 1 1 0 2 5 1 15 d <br /> sB-li C �a 13;-0ar X 0 L4 111 0 2 5 - t <br /> Special Instructions/Comments Relinquished b�,.r Received by r Sample Receipt <br /> EDF Required Please Email Knssy Flesoras at Sign Sign vl,',7 Sof 5 Total no of containers <br /> kflesoras@secor com Print Ben WAght Print .S4we/S Cham of custody seals <br /> Company SECOR Company ,C,rrPIr. Cu Recd in good oondidon/cold <br /> Fax Results to Time I tagk Date 1J/p7,/j)4 Time Date p p Conforms to record <br /> 1)Todd Brown fax 916-861-0430 Relinquished by Received by <br /> Sign Sign Client Secor <br /> Print Print Client Contact Todd Brown <br /> Company Company Client Phone 916-861-0400 <br /> Time Date Time Date ext 233 <br /> SECOR CUSTREC Pw 2M <br /> Date 1)LOY 0'-t Page ?- of � <br />
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