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FIELD DOCUMENTS_CASE 2
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545105
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FIELD DOCUMENTS_CASE 2
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Last modified
12/19/2019 2:20:12 PM
Creation date
12/19/2019 2:16:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
FIELD DOCUMENTS
FileName_PostFix
CASE 2
RECORD_ID
PR0545105
PE
3528
FACILITY_ID
FA0003965
FACILITY_NAME
PG&E
STREET_NUMBER
4040
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95204
APN
11702001
CURRENT_STATUS
02
SITE_LOCATION
4040 WEST LN
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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Chain of Custody Record Pacific Gas and Electric Company Page 1 of 1 <br /> Client Project Manager Date <br /> Preparation and <br /> PG&E Technical and Ecological Services(TES) John Woodruff-PG&E Ow4@p e.c'om) April 1,2004 Analysis <br /> Address Telephone Number Fax Number Laboratory <br /> 3400 Crow Canyon Road. 925.866.5883 925.866.5681 Torrent Laboratory, Inc. <br /> City Zip Code Site Contact Laboratory Phone E <br /> San Ramon JC�A]94583 None 408.263.5258 o w <br /> Project NumbeNName Sampler U <br /> Laboratory Fax � d <br /> M&E Stockton Service Center John Woodruff 408.263.8293 <br /> Contract/Purchase OrderAQuote Number Laboratory Contact <br /> 4600013885 Mukesh Jani m Q <br /> v o <br /> Containers <br /> Sample I.D.Number and Description Date Time Sample Type Preservative Condition on Receipt/Comments a �° v <br /> Volume Type HAI,. 8 � o F o <br /> DPI-5 O d tl -0 o i 31-Mar-2004 Soil 300 cc 1 x x <br /> DP1-7 <br /> DP1-9 fi o0-9 A X <br /> DP2-5 rt —00 X <br /> DP2-7 h —005A X <br /> DP2-9 h rpq,7X <br /> X <br /> DP3-5 �� -=- Cep 7 x <br /> DP3-7 r <br /> DP3-9 X <br /> X <br /> 11 1 <br /> SpeFlat Instructions. ...... <br /> Possible Hazarr!Identification Sample Disposal <br /> ❑ Non-Hazard ❑Flammable ❑Skin Irritant ❑Poison B Unknown ❑ Retum To Client MIDIpsal By Lab MIAhive for 3 Months <br /> TuryAround Time Required QC Leve! <br /> qI! ❑ I!! Project Specific Requirements(Specify) <br /> Normal ❑ sh E3 Other El 1 [1 <br /> ?.Relinquished By Date Time 1.Recefv B Da_�O Mme <br /> John Woodruff 1-Apr-2004 �2 <br /> ;.*I,nq.ish.d <br /> Re' y / e —4f- <br /> 1 T, 2. ived By lign r <br /> / 9 <br /> y Date Time 3.Receive y Date Time <br /> Comments <br /> COC_ �kton_SC.xls page 1 <br />
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