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ARCHIVED REPORTS_XR0006375
EnvironmentalHealth
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2900 - Site Mitigation Program
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PR0528433
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ARCHIVED REPORTS_XR0006375
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Entry Properties
Last modified
4/7/2020 1:06:04 PM
Creation date
4/3/2020 4:46:38 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006375
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
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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I <br /> a <br /> 0 1=- Tool=00571famm <br /> n <br /> J Lancaster LaboratoIries L Z Acct # _ y Sample easter Laboratories use only 5CR# <br /> Wherqualltytsascrence q5 <br /> 077 1-7 62 I <br /> 0,1 b Analyses Requested /r B/ J S � U <br /> Fae ty# 9-6171 Job#385121 Globel IDNT0607700035 Matrix Preservation Codes Preservative Codes <br /> 6633 PACIFIC AVE STOCKTON CA H=HCI T=Thiosuffate <br /> Site Address Q N=HNO3 S=NaOH <br /> Chevron PM Robert CochranLead Consultant SecOr I1u 3 504 0=Other <br /> � � S=H2, <br /> Consultant/office G-R Inc , 6747 Sierra Court Dublin Ca 94568 w r- o 8 M ❑J value reporting needed <br /> c a {0D ❑Must Imeet lowest detecdon limits <br /> Consultant Pn Mgpeanna L Hardin Deanna rink col) a° z o N <br /> FS possible for 8260 compounds <br /> Consultant Phone 9.25-551-75560# 925-551-7899 ❑❑ o O ❑ -4 <br /> ` N 802i MTBE Confirmation <br /> Sampler--6y�e ti r I m ❑ a w 21 ❑Cordi m highest hit by 8264 <br /> y E ❑ [3Confirm all hits by 8260 <br /> Service Order# ❑Non SAR � � <br /> a <br /> Date CL <br /> Time{� 0 Ep o o [3 Run oxy s on highest hit <br /> Sample Identification I Collected Collected 0 8 r0 � O t— m � � � � � ❑Run!oxy s on all hits <br /> 77 G 02- ----n It Comments 1 Remarks <br /> a ;1 YX IQ 1 � <br /> V--3 //q S", Y X, 6 XX <br /> M'V-q haC5 <br /> hi W-5 0 G <br /> ,6 0� KL <br /> So 6KA I <br /> Ism <br /> AW,ta <br /> -r�- <br /> d Z <br /> Reluquls Date Time a Time <br /> Tumaround Time Requested(TAT)(please circle) 7tm <br /> 5 <br /> guTAT72 hour 48 hour Time iv d pat rimer 4 day 5 day 7L�� <br /> Data Package Options(please circle if required) ui Date Time Rece Date Tim <br /> QC Summary T �s3b L%61(Type I—Full Relinquished by Commercial Reos I� <br /> Type VI(Raw Data) ❑Coelt Deliverable not needed Relinqi Date I Time/fes <br /> WIP(RWQCS) UPSl FedEx Other &1A CV <br /> Disk Temperature Upon Recelp C. <br /> Custody ntact? es No <br /> ` Rev 7130/01 <br /> Lancaster Laboratories,Inc,2425 New Holland Pike,P f 2425, ncaster,PA 17605-2425 (717)656-2300 <br /> Copies White and yellow should acoompany samples to Laroc�aboratorles The pink copy should be retained by the client. s <br />
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