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ARCHIVED REPORTS_XR0002413
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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G
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GRANT LINE
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455
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3500 - Local Oversight Program
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PR0545202
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ARCHIVED REPORTS_XR0002413
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Entry Properties
Last modified
1/27/2020 11:09:06 AM
Creation date
1/27/2020 10:27:56 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002413
RECORD_ID
PR0545202
PE
3528
FACILITY_ID
FA0003124
FACILITY_NAME
7-ELEVEN INC. STORE #20304
STREET_NUMBER
455
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
455 W GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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40130 PIKE LANE SUITE GCHAIN-OF CUSTODY RtCORD 4 0 4 �. 7 <br /> E L CONCORD CA 94520 AND ANALYSIS REQUEST(510)685-7652IGOr <br /> ','�;,;;"„',"1,� (1300)423-7143 <br /> Company Narne Phone (916) <br /> I <br /> (91G) 372-11700 � <br /> builtFAX # - i o <br /> Company Address Site Location LIFT /,I LL,, v C r, M <br /> 11101 II71yard Drive f g a = N a <br /> 1 l 1 a L.- C r1 L 9 i d `7 <br /> ❑ <br /> �t+�. 1(14, `r�.S:►c'ralnE-t1to, CA 95GJ + + © a <br /> Project Manager Client Prosect ID (#) a ZL1��l r M a _ w v, , a F <br /> w , <br /> A r O.Store � ,C„ 4T z z ❑ Oa > c _IIt <br /> v7 I attest That the proper field sampling S miller Flame(Print) � d ;, o ^' 17 � L e j� -i n N <br /> T <br /> procedures were used during the ` i o ry or u t a N ' Q N F n° <br /> T collection of these sample I L ,, I u i �, N m �' q (, a o o u <br /> Matrix Method Sampling U a, W a a $ LI ❑ aU. <br /> Preserved r r r- m r rt t �' W W n ' o0 0 ;, <br /> Field GYEl. W - - - _ n q _ t i n_ C <br /> 2 N N i (] ,f PI N O ; Yti O x <br /> Sample Lab ►a- M T �� CL I u a ' S m o a <br /> ID tablJso z I � o a W _ b o w F w $ �; m a a < t Q' o <br /> O 1-117 O <br /> CL p n a a n a a a a U d a <br /> only 3 w Q n p x x x u p� a H m m z z o r-', w w w w w w w w w F ui u o u <br /> 1. j 3 k rr f <br /> Q ' ; <br /> c a f�15 <br /> r <br /> !k, tri <br /> T `rSpr3Cla1 Handling SPECIAL DETECTION LINTS REMAJIKS` <br /> TA1t���(: 114 -L <br /> ±1E 11 <br /> Priority(24 rill 'J GTEL Contact <br /> Expedited{46 hr) ❑ (JA t;,r b) ��(3r?;I ti <br /> t� pe QuoselContract p (t=k. <br /> 1;4 1 WiinessAayc ❑ Confirmation 0 <br /> corer SPECIAL REPORTING REQUIREMENTS Lab Use Only tot 9 Storage Location <br /> d Husiness Date C PO k <br /> QIVOC Leve) Work Order If <br /> fte C CLP 0 other FAX[]FAX <br /> Reyn tsh ¢yImp, 1,01 <br /> r nJl) �1Rece ed , <br /> CD CUSTODY Retmgtash tby f V ' onto Time Received by <br /> -4 <br /> N RECORD <br /> ReUnclulahad by t)nlo Time Received by Laboratory <br /> c Wa U fi <br />
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