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ARCHIVED REPORTS_XR0011657
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545046
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ARCHIVED REPORTS_XR0011657
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Entry Properties
Last modified
12/10/2019 5:56:35 PM
Creation date
12/10/2019 4:42:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011657
RECORD_ID
PR0545046
PE
3528
FACILITY_ID
FA0003700
FACILITY_NAME
CITY OF STOCKTON FIRE STATION #3
STREET_NUMBER
1116
Direction
E
STREET_NAME
FIRST
STREET_TYPE
ST
City
STOCKTON
Zip
95206
APN
16903006
CURRENT_STATUS
02
SITE_LOCATION
1116 E FIRST ST
P_LOCATION
01
QC Status
Approved
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SJGOV\wng
Tags
EHD - Public
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0'885 Jarvis Drive • Morgan Hill, CA 95037 • (408) 776-9600 • FAX (408) 782-6308 <br /> _QUOTA ANALYTICAL ❑ 819 Striker Ave., tie 8 • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-01?` <br /> iz / 11404 N.Wig( Lail ,Walnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-9673 k <br /> , <br /> qW CHAIN OF CUSTODY Cl 1455 McDowell Blvd. North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> ❑ 1551 Industrial Road • San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 P <br /> Company Name: AT A-,soc l kiProject Name: Vm S 109'1 AkL -'y6 ,b <br /> MS <br /> Mailing Address: I tt'l L_0Y12 -T <br /> 0LkkBilling Address (if different): <br /> City: - State: Zip Code: 535 <br /> Telephone:+ C�7 FAX #:2N-579 - Z � P.O. #: <br /> Report To: Sampler: M t'lore.'S QC Data: evel D (Standard) EllLevel C ❑ Level B ❑ Level A U <br /> Turnaround 0 Working Days ❑3 Working Days ❑2 - 8 Hours ❑ Drinking Water Analyses Requested <br /> iL <br /> Time: ❑ 7 Working Days ❑2 Working Days ❑Waste Water <br /> ❑ 5 Working Days ❑24 Hours M/,2/��� J�1,6ther <br /> Client Date/Time Matrix # of Cont. Sequoia's ,`lU�a7'O�� <br /> Sample I.D. Sampled Desc. Cont. Type Sample # Comments <br /> 1. W l2�Lyq i d 8 20 <br /> 2. <br /> 3. Nk W- //3 `-I �3 0 <br /> 4. <br /> 5. <br /> 6. <br /> 0 <br /> _ <br /> Q <br /> m <br /> 8. U) <br /> Y <br /> 9. s <br /> 10. <br /> Relinquished By: Date:Cel 9y Time:,/,oraReceived By �� 3or' Date: 3 Time: �� 000 <br /> Relinquished By: Date: Time: Received By: ?7,I Date: 121, Time: /Z r,o <br /> Relinquished By: Date: Time: Received By Lab: Date: Time: <br /> Were Samples Received in Good Condition? ❑Yes 0 No Samples on Ice? 6/es ❑ No Method of Shipment e'ociri'? ✓ Page of <br />
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