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ARCHIVED REPORTS_XR0006361
EnvironmentalHealth
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6633
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2900 - Site Mitigation Program
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PR0528433
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ARCHIVED REPORTS_XR0006361
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Entry Properties
Last modified
4/7/2020 1:05:00 PM
Creation date
4/3/2020 4:38:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006361
RECORD_ID
PR0528433
PE
2957
FACILITY_ID
FA0019174
FACILITY_NAME
CHEVRON SERVICE STATION 9-6171
STREET_NUMBER
6633
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
09741048
CURRENT_STATUS
02
SITE_LOCATION
6633 PACIFIC AVE
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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EHD - Public
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❑ Yes qk11 IJ 5 <br /> =au copy of Lab Report and COC to Chevron Contact; ❑ NoCha1n-0 "CUS Od ~~ 9C0 <br /> Chevron PactIlly Number 171 Chevron contact (Name)BRETT HUNTER <br /> iTevron Produale Co, <br /> Facnily Address 6633 Pa ifi�`�a_ (Phone)(925) 842-8695 <br /> �,K,� <br /> '.0. 80X 8004 Consultant Project Number Laboratory Name SEQUOIA <br /> Consultant Name BLAINE TECH SERVICES, INC. Laboratory an Ramon, CA 98583 1680 ROGERS AVE. , SAN JOSE ry service Order -9 144488 <br /> Ax (925)842~8370 Address Laboratory Semite Cade 28O <br /> l r <br /> Project Canlac4 (Name) CHRISTINE LILLIE Samples Colleclad by (flame) <br /> (Phone) 408-573-0555 (Fox Number) 408-573-7771 5lgnnture <br /> State Method: ❑ CA ❑ OR ❑ WA ❑ NW Series ❑ CO ❑ UT Remarks <br /> amu , <br /> $ r z <br /> 910 <br /> .. <br /> Lab Sample No <br /> 0 <br /> X - 6L <br /> Av s X <br /> Evia— � 3 ✓ 1�g�.o � _ �,,1 <br /> V /$3S 0J <br /> i <br /> 66 <br /> X <br /> J. <br /> iqufrhed By (Signal drganlra#fon Oale/T Recefvad 9y {51 nature) Organlrollor► pale/Time Iced Y/H Turn Around Time (Circle Choice) <br /> 24 Urs �� 1 <br /> �ilshed B (5lgnalure) Organtrallon Dole/Tlme Recelved 8y (Slgnalum Organlra#lon Date/Time Iced Y/N 48 We i <br /> 8 Days <br /> "14 By ( ) Organization ST nolure Or tion pale 10 Days <br /> 4 4 /Time Reclaved Far Laboratory 13y (Signature) Daly/Time tced�F) As Can#reeled <br />
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