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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
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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QUALITY <br /> FIRM =7/l Z��t� l; Ute ,� �,-,, CONTROL ORDER NO. / <br /> �� NAME REPORT SAMPLE DATE <br /> ��,J ❑ PRIORITY <br /> ANALYTICAL LABORATORY ADDRESS (perform all SAMPLED BY <br /> OC on this <br /> 1910 S STREET client's sample DATE REC'D <br /> SACRAMENTO, CA 9 1,4 PHONE report <br /> (916) 447-2947 ❑ ROUTINE TIME RECD <br /> FAX (916) 447-8321 ANALYSIS REQUESTED BY: (report regular <br /> l ANLAB will perlorm the services In accordance with the normal standard of workmanship In the -batch"QC) <br /> SAMPLE RECEIVI G FORM ;ha'llnsot exceed the Invoded Amountt to(said officers, <br /> ervice%nClients employees <br /> c eptn ceuof a work order and/or ❑ No Report RECEIVED BY <br /> proposal releases ANLAO hom any liability In excess of the Invoiced amount for the services, Required DELIVERED BY <br /> notwithstanding any provision to the contrary In any client purchase order or contract. <br /> SAM. TYPE CONTAINER PRESERVE <br /> w cc <br /> o <br /> STATION W J f m 2 m W n <br /> Z �a cc <br /> z <br /> o DESCRIPTION 1=Q CL <br /> ANALYSIS CODE CONTACTED: <br /> CONTACTED BY: <br /> SAMPLING USH: W-Water <br /> HOUR 1NW-Wnste Water DATE/TIME: <br /> MILES GW Ground Water <br /> 24 HOUR SW-Surface Water <br /> Office Use Only: <br /> HOURS qg H R S-Son <br /> SL-Sludge <br /> E o-oil <br /> REMARKS: All non-aqueous or hazardous samples will be returned to client 30 days after reaulls <br /> are reported unless alternative arrangements have been made.Samples disposed of by <br /> Anlab will be billed to client at cost. <br /> SAMPLE DISPOSAL INSTRUCTIONS: <br /> ❑ Rel rn'lo Client Date Completed/initials: <br /> Routine Lab Disposal <br /> Other <br />
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