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ARCHIVED REPORTS_XR0006389
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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6633
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2900 - Site Mitigation Program
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PR0528433
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ARCHIVED REPORTS_XR0006389
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Entry Properties
Last modified
4/7/2020 1:14:37 PM
Creation date
4/3/2020 4:56:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006389
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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�� �� ttttttttlltl� w s � � s_ fi• f� ■� t_ � I• � I• � � r• <br /> Far Lancaster Laboratoriss use only f 0L) ' q-7/0-7 90 <br /> LarxaAer Laborab ies qcq # _ Sample# Ll7()aZalSGRti <br /> o 2A 1,4b—0S Analyses Requested <br /> Matrix Preservation Codes Preservative Codas <br /> Facility# S#9-6171-0ML GR#385121 Global ID#T0607700035 41 H=HCI T=Thiosul/ate <br /> Site Address0633 PACIFIC AVENUE, STOCKTON,CA N=HNOa B=N90H <br /> . O=Other <br /> Chevron PM{}R Lead ConsulLaMSECOPGI" S=H2SO0 J value reporting needed <br /> Consultanttofrlce Gid, Inc„ 8747 Sierra t.olili,Stslte J, Dublin, Ca 9456$ to <br /> D U ust meet towest detedson Vn ffs <br /> Deanna L Hardin (deanns nno com a rot 8Z$0 conaperunds <br /> Consultant PrJ Mgr g n <br /> O❑ © ❑ W21 MTSI Gnrdirr,raaon <br /> Consultant Phone# Fax# 9 ❑Confirm highest tut by 8M <br /> Sampler © Ean # ©Cordirm all hitsby 8260 <br /> Seance Order# ©Man SAR $ ❑Run_oxy s on highest hit <br /> D me Time 3 ° I ❑Rrai oxy s on all huts <br /> SampleIdentification Collected Collected v� 1 <br /> 8 O Comments f Remarks <br /> w- PL tftSF— <br /> o j 0 CLULPF PcfE <br /> Uf- G RRFRAS <br /> - S [--0L WELLS <br /> AAW T <br /> ur- <br /> Re Date Tame Received by, ate Time <br /> Turnaround Tuna Requested(TAT)(please dale} <br /> 0 to Time Received <br /> 5 TAT 72 hoar 48 hour Rslinwished by t C J <br /> 24 hour 4 day 5 day D <br /> Rellnqutshed by- 0 Time Received / o Time <br /> Data Package Options(please circle IN required) � t _�� t S� �fit L 2-VO6 15 <br /> OC Summary Type 1---FullDote Time <br /> Type VI(Raw Dotal [30mill Dal wabte not needEDFIEDD Re6r�utshed by d xnnlerdal Garner R�'�by <br /> MP(Rwc2c9) <br /> UPS FedEx Ocher ) Ibiol. I 0q05 <br /> Disk Temperature Upon Receipt Imice5_ No <br /> Lancaster Laboratories,Inc,2425 New Holland Pike,PO Box 12425 Lancaster,PA 17605-2425 (717)655-2300 3460 Rev 7!30101 <br /> Copies Whyte and yellow should accompany samples to Lancaster LaboMoios The pink copy should be retalned by the drsnt <br />
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