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COMPLIANCE INFO_CASE 1
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COMPLIANCE INFO_CASE 1
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Last modified
3/20/2020 5:55:33 PM
Creation date
3/20/2020 3:00:04 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
COMPLIANCE INFO
FileName_PostFix
CASE 1
RECORD_ID
PR0517531
PE
2950
FACILITY_ID
FA0013493
FACILITY_NAME
CHEVRON SERVICE STATION #201761
STREET_NUMBER
1103
Direction
S
STREET_NAME
MAIN
STREET_TYPE
ST
City
MANTECA
Zip
95336
APN
21935038
CURRENT_STATUS
01
SITE_LOCATION
1103 S MAIN ST
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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r QUALITY <br /> FIRM /� Uri/ ����;�1/,_ 7� J L-- _ CONTROL ORDER NO.' ' 13 S 1 <br /> ft <br /> tabNAME ��"i'' •'�� -i �`f'1� �� REPORT SAMPLE DATE <br /> ❑ PRIORITY <br /> ANALYTICAL LABORATORY ADDRESS (perform all SAMPLED BY <br /> QC on this <br /> 1910 S STREET client's sample DATE RECD <br /> SACRAMENTO, CA 95814 PHONE report) <br /> (916) 447-2947 �r` � ' �/Jt` j ❑ ROUTINE TIME RECD <br /> FAX (916) 447-8321 i ANALYSIS REQUESTED BY: / � (report regular <br /> ANLAB will perform the services in accordance with the norrrl Iletandard of workmanship in the "batch"QC) <br /> profession.The total liability of ANLAB,Its officers,agents,employees,or successors,to the client, RECEIVED BY <br /> SAMPLE RECEIVING FORM <br /> shall not exceed the invoided amount for said services.Clients acceptance of a work order and/or No Report <br /> proposal releases ANLAB from any liability in excess of the invoiced amount for the services, <br /> notwithstanding any provision to the contrary in any client purchase order or contract. Required DELIVERED BY <br /> J SAM. TYPE CONTAINER PRESERVE <br /> w cc <br /> O STATION w� �, .'i �. m a—i c`nn m m w a v <br /> d DESCRIPTION Q ,y t: cmc Q_ ,�� g g Cr z o z w l <br /> cn .� �... t O � a C7 co cn Q <br /> r� J•"� a <br /> iI I A/ <br /> ANALYSIS CODE CONTACTED: <br /> SAMPLING W=water CONTACTED BY: <br /> `8 YI�UR WW=Waste Water <br /> MILES GW=Ground Water DATE/TIME: <br /> 24 HOUR SW=Surface Water <br /> HOURS 48 HOUR S=Soil Office Use Only: <br /> 1 WEEK SL=Sludge <br /> O=Oil <br /> -7 / <br /> REMARKS: All non-aqueous or hazardous samples will be returned to client 30 days after results <br /> are reported unless alternative arrangements have been made.Samples disposed of by <br /> Anlab will be billed to client at cost. <br /> fl 1 f SAMPLE DISPOSAL INSTRUCTIONS: <br /> l <br /> Ja: jlc t., w,c-� � ❑ Return to Client Date Completed/Initials: <br /> Routine Lab Disposal <br /> 0 Other <br />
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