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ARCHIVED REPORTS_XR0012056
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0541875
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ARCHIVED REPORTS_XR0012056
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Entry Properties
Last modified
3/16/2020 6:00:21 PM
Creation date
3/16/2020 2:24:54 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012056
RECORD_ID
PR0541875
PE
2960
FACILITY_ID
FA0024017
FACILITY_NAME
CHEVRON SITE 306415
STREET_NUMBER
437
Direction
E
STREET_NAME
MINER
STREET_TYPE
AVE
City
STOCKTON
Zip
95202
APN
1392417
CURRENT_STATUS
01
SITE_LOCATION
437 E MINER AVE
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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❑ 680 Chesapeake Drive•Redwood City,CA415)364-9600 ❑ 18939 120th Ave,N is,Suite 101 •Bethell,WA 98011•( 481-9200 <br /> El819 Sinker Ave,Sude 8•Sacramento,CAV9 .-(916)921-9600 ❑ East 11115 Montgomery,Suite B•Spokane,WA 99206• 924-9200 <br /> UNtCAL ' ❑ 1900 Bates Ave,Suite LM-Concord,CA 94520-(510)686-9600 ❑ 15055 S W Sequoia Pkwy,Suite 110•PorBand,OR 97222•(503)624-9800 <br /> Company Name G E T T ` K• r �� + Protect Name �� NVCA Vr(� }r. j <br /> Address 0 G �M� $21 G /r NOCAL Project Manager G C SO <br /> City A Ki I�Q UitpoI tate zip Code 0 Release# <br /> m <br /> %. 3 FAX# 1111 6- 3�- 1317 site# <br /> Telephone ],,, ra <br /> oG Sam le DC Data Level D(Standard) ❑ Level C ❑ Level B <br /> Reort To ❑ Level A <br /> Turnaround K 10 Work Days ❑ 5 Work Days ❑ 3 Work Days ❑ Drinking Water <br /> Anal ses Re nested <br /> Time 1:12 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Misc ❑ Detect I&Eval ❑ Remed ❑ Demol ❑ Closure ❑ Other <br /> Client Date/Time Matrix #of Cant Laboratory ` Comments <br /> Sample I D Sampled Desc Cont Type Sample# <br /> oil /110 5 s I d l l <br /> m <br /> 2 Wz6 - 71 Itl <br /> 1 ~� 3 <br /> 3 u .-Z 1z7- 7S S o <br /> 4 JA —7(P m) <br /> 5 1-9& r KS 5 /I 50 <br /> 6 u-Z�v 90.5 /201 <br /> 7 (A-2(o <br /> e11A -Z(s --/Osrj 1301r <br /> r� <br /> 9 - 2 6 -- �J 1 /3/Z <br /> r <br /> 1 o tAI1S.5 �3 Z ° <br /> Relinquished By <br /> Date 05 L Time /3 00 Received By Dat Ot'Z Time y , <br /> � <br /> L <br /> Sic�a,f��2, Time _� ReceivedB Time 13°S <br /> Relinquished By <br /> Date? <br /> 2F-4 I <br /> -A* <br /> Date Time ReceivedB Lab Date Time <br /> Relinquished B <br /> Were Samples Received in Good Condition?0 Yes 0 No Samples on Ice? 0 Yes 0 No Method of Shipment Page—of <br /> To be completed upon receipt of report <br /> e Chain of Custody reported ❑Yes 0 No If no, what analyses are sill! needed <br /> 1) Were the analyses requested on th <br /> 2) Was the report issued within the requested turnaround times ❑Yes O No if no,what was the turnaround times Date <br /> Approved by <br /> Signature Company <br />
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