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ARCHIVED REPORTS XR0006298
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 XR0006298
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Entry Properties
Last modified
10/18/2019 9:16:59 AM
Creation date
10/18/2019 9:10:53 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006298
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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Chain of Custody Number 3 Z7� <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 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 <br /> Laboratory Kiff Analytical N N <br /> Turnaround Time Standard <br /> c m v55� c <br /> Q 'p a a h 0 O C N C <br /> Sampler's Name Tom Miller © X m � a R m cc <br /> °Sampler's Signature E 2 N a = o 0 N <br /> s a Comments/ <br /> Sample !D Date Time Matrix = = a w <br /> Instructions Z <br /> MW-1 /7-e,3 13 of Water X X <br /> MW-2 L/-/-7-,,.7 /3Y0 Water X X —02 <br /> U <br /> MW-3 y47-o:; I 20 Water X X —03 <br /> Special Instructions/Comments Relinquished by ived by Sample Receipt <br /> 7 Oxygenates TAME, MtBE, EtBE,TBA, DIPE, EDB & Sign Sign Total no of containers <br /> 1,2 DCA Print dy,,. /6 Print Cham of custody seals <br /> Global ID#T0607700351 (SIRC) Company �� Company Rec'd in good condition/cold <br /> EDF Deliverables-Email Molly Koch at Time 14lS Date g o Tim Date Conforms to record <br /> mkoch@secor com DPrint <br /> d by Received by <br /> email results to bcarey@secor com Sign ` � Client SECOR <br /> Print r• �� Client Contact Brian Carte <br /> Company ClientPhone 916 861-0430 <br /> Date Time Jyr9 Date d o ext 241 <br /> 9ECOR CUSTREC Rw 2MO <br /> Date Page /c.=/ <br />
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