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ARCHIVED REPORTS_XR0006378
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_XR0006378
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Entry Properties
Last modified
4/7/2020 1:12:51 PM
Creation date
4/3/2020 4:48:38 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006378
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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Chevron California Region ' • • ofCustody <br /> #Lamaster Laboratories 1 a�o o J- fFor L caster oratories us only <br /> VI�lere �rlc� I Acct # Sample# 7o O ' � SCR# <br /> I Analyses Requested If <br /> Facility# 9-6171 JOB #385121 Matrix Preservation Codes Piaservative Codes <br /> i H=HCI T Thiosutfate <br /> Site Address 6633 Pacif is Ave. , Stockton CA C N=HNO3 B=NaOH <br /> Chevron PM Robert Cochran Lead Consultant Secor S=H2SO4 O:Other <br /> 12 <br /> 0w c ❑ ❑J value reporting needed <br /> Consultant10f1iceC—R Inc. 6747 Sierra Ct. Dublin, CA 94568 B o I <br /> 0 0. N S ❑ <br /> Must,meet lowest detection limits <br /> Consultant Pq Mgr manna I L Harding Deanna@grinc.co v possible for 8260 compounds <br /> Consultant Phone# 925-551-7555 Fax# 925-551-7899 0 Cf o 8021 MTBE Confirmation <br /> Sampler Brian Gan ❑ M W g o �onfrm highest hit by 8260 <br /> E m � ❑Connrrn ail hits by 8260 <br /> Service Order# `� Q ' ll <br /> ❑Non SAR � � � Z + � $ � � � _ , ❑Run i oxy s on highest hit <br /> i Date Time, - m <br /> Sample Identiflcatlon i Collected Collected v N O o ©Run oxy s on all tilts <br /> 42 TBLB Comments 1 Remarks <br /> V ,_ S ,� , <br /> i , <br /> MLA, J1±SS <br /> X 1 13 <br /> k <br /> I h �' i <br /> 3 " : l <br /> I i <br /> Reli fished by Date Time R iv by I Date Time <br /> Turnaround Time Requested(TAT)(please circle) fA41 0,�f 1 j <br /> bl 3Sa <br /> 4;D�T <br /> 72 hour) 48 hour ehnquished by —Z56'- Time, Received by I D m <br /> 4 day 5 day 1 <br /> Data Package Options(please circle H required) Relinquished Date Time ed by Date Time <br /> QC Summary Type f—-Full Relinquished by Commercial Carrier Received by to Tirre <br /> Type VI(Raw Data) [ICoelt Deliverable 1 UPS FedEx Other not n4eded / l d <br /> WIP(RWQCB) <br /> Disk !Temperature Upon Recei � C° Custody Seals Intact Yes No <br /> I 3460 Rev 713010 f <br /> Lancaster Laboratories,Inc,2425 New Holland Pike,P x 12425,Lancaster,PA 17605-2425 (717)656-2300 <br /> I Copies White and yellow should accompany samples to Lan Laboratories The pink copy should be retained by the client . <br /> I <br />
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