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ARCHIVED REPORTS_XR0007182
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_XR0007182
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Entry Properties
Last modified
11/20/2024 9:21:19 AM
Creation date
9/5/2019 1:50:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007182
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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EHD - Public
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Chain of Custody Number I S <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento U Additional documents are attached, and are part of this Record <br /> Address 3017 Kilgore Road,Suite 100 Job Name Time 011 <br /> Rancho Cordova,CA 95670 Location 14000 East Highway 88 <br /> Lockford, CA <br /> I� <br /> Project# 770T 41737 00 Task# 0003 Analysis Request <br /> Project Manager Todd Brown am <br /> Laboratory ExelChem '920. �, ,�-� <br /> Turnaround Time Standard ; <br /> D, , 6 <br /> c M m <br /> A /dY2g <br /> m TU <br /> oXV � M <br /> Sampler's Name Daman Minarich mU <br /> ze <br /> 9 ' R <br /> Sampler's Signature om£ n `� ~ m m m N N a y <br /> r u� m ui - °� '_ —L °� _ a Co Comments/ <br /> U �. O TO ~ nE O N c6 m N m 0 070 m U 7 <br /> Sample ID Date Time Matrix = �- eo W m W co in z 0 toa � � � a � i— Instructions z <br /> QCEBjoy Water X X v��° 6 <br /> QCTB Water X X 0 P1 &Td l 3 <br /> 0 <br /> Special Instructions/Comments Relinq i hed bReceived by Sample Receipt <br /> EDF Required Please Email Krissy Flesoras at Sign ign Total no of containers <br /> kfiesoras@secor cam Print D o41rll � <br /> rich Print Chain of custody seals <br /> Company SECOR Company Recd in good condition/cold <br /> Fax Results to- Time Date Time Date Conforms to record <br /> 1)Todd Brown fax 916-8614)430 Relinquished by Received by <br /> Sign Sign Client Secor <br /> Print Print Client Contact Todd Brown <br /> Company CompanyClient Phone 946-861-0400 <br /> Time Date Time ffi_LDate <br /> r- ext 233 <br /> recon cusmREc rt,ZW <br /> Date Page 2 of 2 <br />
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