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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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r <br /> 4080 PIKE LANE, SUITE C RAIN-OF-CUSTODY RECORD W0417 <br /> CONCORD, CA 94520 AND ANALYSIS REQUEST <br /> 52 <br /> IGTE L �B00)423-7x43 1 1 ER <br /> 1 Y O 41 MIy1 <br /> Ia.q. lOa fl C <br /> Company Name Phone (916) 372-4700 <br /> FAX 916 377-8781 m ❑ <br /> Company Address Site Location q55 &ra.n+i me(� 16 00 ❑ 110 � <br /> 1401 Halyard Drive TY 13F] 2❑ V; cc <br /> Ste. 140, W.Sacramento, CA 95691 t 0 2 <br /> 1 iD N a ❑ p <br /> Project Manager Client Project ID ( ) Store #Z03a�{ rl 9 N W' N <br /> if <br /> r <br /> STH�.102070na3 5o m UL o ❑ ❑ ❑ CIS <br /> JaZ z o ° ❑ <br /> I attest that the proper Held sampling S pier Name{Pant) © �' ❑ o �� [< , ❑t) [ ] <br /> procedures were used during the 0 p cc o a N In (L U �� CO <br /> 4444 ❑ $ ❑ a <br /> collection of these samples t d ,� o H ° `gj Cy o 0 ID a t� $ <br /> Method Sam lin D `� �� N <br /> Matrix Sampling Lt w L] t� 2 ❑ d a af <br /> Preserved °° a 1 Il w W s Fj n <br /> Field GTEL -- — F - — - NI �, d `° [1 I t Ll a u ' r4 a <br /> Sample Lab I- ccw a a _ (D Q o N $ <br /> ID Lala Use z w p A w o "w w w w x W rUV a a a a a a a a I �r' <br /> ( O a cc 0 (] z N w z W a Fw F a a a a a a s a. U a e <br /> +-7 <br /> I- <br /> only O� a vJi a o = = c� =N o- a m m w w w w w w w w r O U <br /> % X `�? 4 F <br /> 12*5 <br /> 63 � f� <br /> MU) e� <br /> r <br /> 1 <br /> U-)-V) cS � S <br /> 1 , <br /> O <br /> i t S <br /> 1 <br /> 7i 1 ft S �r 1 �1 Lam] L <br /> Special Handling 1 SPECIAL DETECTION LIMITS REM w R W` <br /> TAT GTEL Contact � �, 1^- <br /> Pnority(24 hr) Ll �._ a 1i AD �i f M <br /> Expedited(48 hr) ❑ QuotelContract# U�" <br /> 7 Business Days ❑ Confirmation# <br /> other_ SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot Storage Location <br /> Business Days 11 PO # 0 <br /> 0A/0C Leve . t Work Order# ` <br /> Blue L7 CLP I 1 Other L 1_, _ _ FAX❑ <br /> Retro is d mpl r Date Tima- d b <br /> av Is co t/�JQra <br /> CUSTODY rRelirnquTshod <br /> Ish by Date Time Received by <br /> RECORD <br /> by a Received by Laboratory <br /> t;j1 Waybill# //" � _ <br />
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