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ARCHIVED REPORTS XR0006296
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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YOSEMITE
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1048
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3500 - Local Oversight Program
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PR0544939
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ARCHIVED REPORTS XR0006296
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Entry Properties
Last modified
10/18/2019 9:17:08 AM
Creation date
10/18/2019 9:10:41 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006296
RECORD_ID
PR0544939
PE
3528
FACILITY_ID
FA0000508
FACILITY_NAME
7-ELEVEN INC #17647
STREET_NUMBER
1048
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95337
APN
21903003
CURRENT_STATUS
02
SITE_LOCATION
1048 W YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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1 <br /> Chain of Custody Number <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento 0 Additional documents are attached, and are part of this Record <br /> Address 3017 Kilgore Road, Suite 100 Job Name 7-Eleven Store#17647 <br /> Rancho Cordova, CA Location 1048 West Yosemite Ave <br /> Manteca, California <br /> Project# 77EL 17647 03 Task# 0410 Analysis Request <br /> Project Manager Jaff Auchterlonie o <br /> Laboratory Kif#Analytical <br /> Turnaround Time Standard � c <br /> > O � a cJ <br /> Sampler's Name T Miller ° E� m S ro m <br /> m ao S?? N m� mo yN mN m <br /> Sampler's Signature o �, E � � a Comments) <br /> _ 1 <br /> o a " o CD N ° a Instructions z <br /> Sample ID Date Time Matrix = m r a t (D _ co (n (D r W <br /> MWA <br /> 7 iL/o3 1 3d Water X X <br /> 5 Water X X O <br /> MW-2 c a <br /> MW-3 Water X X <br /> Special Instructions/Comments Relinquished by i,�.�/�//« Received by Sample Receipt <br /> Total no of containers <br /> 7 Oxygenates TAME, MtBE, EtBE,TBA, DIPS, EDB& Sign Sign <br /> 1,2 DCA - Print Print Chain of custody seals <br /> Global ID#70607700351 (SIRC) Company Time Com Recd in good condibonlcold <br /> � ate o T e Date Conforms to record <br /> EDF Deliverables -(email EDF to mkoch@secor.com) .� D <br /> � - <br /> email lab report to dherzog@secor com Relinquished by Received by <br /> Sign Sign Client SECOR <br /> Print Print t-� w Client Contact Brian Care <br /> Comp Company Client Phone (916)861-0400__ <br /> Tim Date Time f to b ext.241 <br /> SECOR CLMTRE`K°"2.= Date Page ���/ <br />
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