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ARCHIVED REPORTS_XR0006938
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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PACIFIC
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5606
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2900 - Site Mitigation Program
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PR0541401
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ARCHIVED REPORTS_XR0006938
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Entry Properties
Last modified
4/14/2020 2:21:25 PM
Creation date
4/13/2020 4:00:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006938
RECORD_ID
PR0541401
PE
2950
FACILITY_ID
FA0006046
FACILITY_NAME
UNION OIL STATION #5098
STREET_NUMBER
5606
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
CURRENT_STATUS
02
SITE_LOCATION
5606 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\sballwahn
Tags
EHD - Public
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� Ju '�AI'I� IM MOO -�roo�, CAM63 4" 36 ,0 ' 92300 <br /> u /► C, 71 Ll 819 VoaA*e <br /> Ave , Suite 8-Sacramento, CA 95834- (916) 921-9600 FAX 16 921-0100 <br /> %/ CHAIN OF CUSTODY a; ❑ 404 N Wiget Lane -Walnut Creek, CA 94598- (510) 988-9600 FAX (510) 988-9673 <br /> [Address <br /> ompany Namer•�i ro h.w.aU _oLv.�tlww- - G Project Name Z � <br /> y .�,.X e J, Sum Billing Address(if different) <br /> City N State O-A- Zip Code q yq%j,1 <br /> Telephone FAX# y I)�3�2.•(yr(� P O # <br /> m <br /> Report To m,44- Oc,'-� �FSampfe-rLa.-Ctr- <br /> QC Data 2"Cevel D Standard) ❑ Level C ❑ Level B ❑ Level A U <br /> Turnaround U10 Working Days ❑ 3 Working Days ❑ 2-8 Hours ❑ Drinking Water lAnalyses Requested 9 <br /> Time. I]7 WorkingDas a. <br /> Y ❑ 2 Working Days ❑ Waste Water �� <br /> ❑ 5 Working Days ❑ 24 Hours t l�lV�� ❑ Other <br /> K <br /> Client Date/Time Matrix #of Cont Sequoia's <br /> Sample I D Sampled Desc Cont Type Sample# C Comments <br /> ra°'' <br /> Ir6 <br /> 3 3 <br /> 0 <br /> m <br /> 4 S- 1,0- 19 23 so y" <br /> s S- 30-1k F z3z3 �i <br /> 7 S -3f'/� -/-23 - <br /> 23 - r al <br /> Cr110 <br /> Relinquished By _ g 6&4e-V--1U Date Time)Yoo Received B Date Time /1/GO <br /> Relinquished By Date rime Received By Date Time <br /> Relin uished By Date Time Received By Lab Date liq ,me <br /> Were Samples Received in Good Condition?13 Yes❑No Samples on Ice? ❑Yes O No Method of Shipment Page_of _. <br /> t <br />
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