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ARCHIVED REPORTS_XR0012231
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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P
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PACIFIC
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4707
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3500 - Local Oversight Program
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PR0545229
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ARCHIVED REPORTS_XR0012231
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Entry Properties
Last modified
1/24/2020 1:18:02 PM
Creation date
1/24/2020 12:23:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012231
RECORD_ID
PR0545229
PE
3526
FACILITY_ID
FA0003903
FACILITY_NAME
TOSCO CORPORATION #31258
STREET_NUMBER
4707
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
10816004
CURRENT_STATUS
02
SITE_LOCATION
4707 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> � .w. �ti _••...+-' .....�..as — .rrirw • - .... - .. .•.•• - r . .a <br /> a.r� ar • <br /> ' C_LILNI NAME. DATE Receised at lab' (Drinking%atep)for <br /> P IC•BY(k'TUNT) TIME Reeci}cd Fit Loh. regulatory}rurposrs YJ; <br /> r {S�'aslc�rater)fay <br /> LOG LN DATE; <br /> regulu(ary purpose8' Y ,D <br /> CIRCLE THE APVR0I't1ATF IMSPONSE I,AR 5Ar1iPJX DATE <br /> SAMPLE # C JENTJD DLrSCftlt'TION MA'littX SAIVIPJAU) CONDITION( IC} <br /> 1 Cos#odd•Sealta) Present UA sen 4 .� 12- <br /> Intact I [o C11* <br /> 2 Chain Of-CUstod Present hk��e[Et* <br /> 3 Traffic Reports or <br /> Packing 1 10 Present f sen <br /> h Airbill Aub[Ilf Sti er <br /> Prescnif <br /> 3_Airbtll# <br /> G Sam le Labels [ e J 1Abeent <br /> 7 Sample IUs Not T igtcd <br /> r <br /> atn-af-Custo�l <br /> $ $dmplc C01011011 nlac Broken"! <br /> i m • <br /> 9 Does information on r <br /> culludy mporLs,traria <br /> reporfs and sinyle - <br /> labels a e7 Yes No* <br /> 14 Sample reccived within <br /> f <br /> halts time No* <br /> I 1 Prover Preservatives <br /> usedfe"9Y No* <br /> 12 Temp Rec at Ub <br /> [Acceptance:range for 9a111PI s <br /> mqu irin thermal pres 4f!-20C YoslNo* <br /> 4x�wocvxbr_.+.v..+�r,aveeweceeswr�cscvv wacvsrt4w.. <br /> *If Circled,enjitact Project Manager and attach i evoi d of resnlutton. <br /> Sample Here#pt Log <br /> Revision 2 1(11MOW) Page---Of <br /> tReplaaes Revision 2(1 1105M) <br /> Cffectrwo 11112M <br />
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