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ARCHIVED REPORTS_XR0006377
EnvironmentalHealth
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2900 - Site Mitigation Program
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PR0528433
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ARCHIVED REPORTS_XR0006377
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Entry Properties
Last modified
4/7/2020 1:09:37 PM
Creation date
4/3/2020 4:47:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006377
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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SJGOV\sballwahn
Tags
EHD - Public
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k <br /> Chevron California Region Analysis RequestlChain� of Custody <br /> +Lzmaster Labor <br /> to ` For nwste Lal�onrtorie use only <br /> rs ascrerice l Acct # �_ sample# 7 'y _ SCR# <br /> Analyses Requested <br /> Facility# 9-6171 Job#385121 Global ID#70607700035 Matrix Preservation Codes Preservative Codes <br /> Site Address6633 PACIFIC AVE STOCKTON CAH=HCl T=Thiosulfate <br /> n N=HNO3 B=NaOH <br /> Chevron PM Robert Cochran Lead Consultant SeCOT m S=H2SO4 0=Other <br /> m m ❑J value reporting needed <br /> Consultant/Office G R. Int:-1.6747 sierra Court r]+ i Win, Ca 94MB 3 o C � 8 'Q ❑Must meet lowest detection limits <br /> Consultant P9Mgr o Z o m rn pos f ble for 8260 compounds <br /> ❑❑ U ❑ ❑ <br /> Consultant Phone# Fax# o W 0 ❑ 8021 MTBE Confirmation <br /> 925a5�-7555 A �, rr N <br /> y <br /> E <br /> � <br /> rrhighest hit by 8260Sam ler 0 &(< <br /> LU g � <br /> ❑Confirm all hits by 8260 <br /> Service Order# 0 Non SAR 0 L a z <a I <br /> C m ❑ + ❑Run oxy s on highest hit <br /> Date Time o o — o <br /> Sample identification Collected Collected c9 U O t— m ❑Run oxy s on all hits <br /> i <br /> Comments 1 Remarks <br /> it l <br /> 4 Z <br /> rem-, C Ib E <br /> oat <br /> rti � <br /> a <br /> k <br /> i r< <br /> 4XN I I A 1,,"4f <br /> cti t <br /> i Relin ed by patq Time b i Date Time <br /> T e Requested(TAT)(please arcle)10�- t/� ! �o J� 1 4 - fl& i I Q °�+ <br /> STD TAT 72 hour 48 hour I Dat Time R ITto Tlrne <br /> ' {. <br /> 4 day I 5 day I 'D <br /> I <br /> Data Package Options(please circle if required) Rel qu shed by Date Time R ived by to Time <br /> OC Summary 1-1)—a 60D � ..11— <br /> rY Type I---Full Relinquished by Commerce! Rete D e Time <br /> Type VI(Raw Data) ©Coelt DeGverabie not needed <br /> WIP(RWQCB) ' UPS FedEx Other o V y l� <br /> Disk I Temperature Upon Receipt _CO Custody Seats Intact? Yes No <br /> � I 0 <br /> • I Lancaster Laboratories,Inc,2425 New Holland Pike, ti 12425,Lancaster,PA 17605-2425 (717)656-2300 Rev 7130!01 <br /> Copies White and yellow should accompany samples to txxatories Tire pink copy should be retained by the diem <br />
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