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ARCHIVED REPORTS_XR0002415
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_XR0002415
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Entry Properties
Last modified
1/27/2020 11:25:03 AM
Creation date
1/27/2020 10:36:04 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002415
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 CHAIN-OF-CUSTODY RECORD GT CONCORD CA 94520 '40319 <br /> ,o•�,•, (510) 685 7852 AND ANALYSIS REQUEST <br /> ^ •_ (800) 423 7143 <br /> Company Name Phone N <br /> M�� �� Sri FAX El ❑ <br /> Company Address Site Location yS5 w� ❑ z arY01 thl1 QJ 3v1k /'YO ❑ <br /> ❑ U <br /> t/ C_ rn co ❑ ❑ m �+ ¢ <br /> Project Manager S t Client Project ID (11) kbla�r �Ip p� # 0 *-di + ❑ <br /> 1 Q h rj <br /> ❑ <br /> r T d H cn rn <br /> Y S L 11� '�' ILL 5 ❑ 0 D ❑ Z a) ❑ Q? C3 w <br /> 11ltesl Ihill Iho proper meld Sampling Sampler Name(Print) ❑ in aE ❑ ❑ ¢ <br /> procedwo';wire used during the ° R o EI VA ❑ `o -J -J v m 5 U N ❑ <br /> coltcclion of these samples t Z a cy ❑ "o a "' Q ❑ m a a u m o f rte- <br /> j R n o a o a o Ua = ❑ a. m ❑ a <br /> Method `9 °i " rq m Q m C ❑ r, C3 a p c ❑ ^ c 1 <br /> Matrix Sampifng s o d o a o °° m o E] a o c� <br /> Field GTEL Preserved a a. y ❑ ❑ w a a. o ❑ ❑ �; H ❑ a 8 ❑ U. <br /> z p z c c m T P iu w m -+ w in a ❑ a <br /> Sample Lab# M.-- ..o <br /> -e O ❑ ❑ a a ❑ mJiD (Lab Use} a W J o WW wr w w x E a tn W w E0 (0 w o Nonly a o ¢ E p NZ¢ a r M % 4 i° a o a 4 a a a nd 4 a v a ao r m z _ N O_ o m in a x 0 r w w w w w w w w w t- w U a U <br /> 1130 <br /> 1"T <br /> 0M � I _ r <br /> �r � l�31 r <br /> y - <br /> ---- - - <br /> a ahl, till <br /> ./y <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS P!J I <br /> r rionly(24 hrt i GTEL Contact _ <br /> Fapndited(48 hrl Quote/Contract 0 <br /> 7 Business Drys i <br /> CO <br /> Other rehrmali0n i! _ <br /> fluiriness Dlys I i PO N _ __ SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot 4 Storage Location <br /> QAIQC Level -*1%.r Ndsp'A 1� <br /> Blue I CLP i I Other r_I — 54 FAX❑ WorlrOrd r# Y <br /> Relinquished by Samplerat Time c ed b <br /> CUSTODY ' J ix 1 I1*3U <br /> RECORD Rikl'n wished by t me ed by <br /> 1) t .0 — <br /> Relr qs by Time Received by Laboratory <br /> w -Waybill 4 t p <br />
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