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ARCHIVED REPORTS_XR0012385
EnvironmentalHealth
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3500 - Local Oversight Program
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PR0545638
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ARCHIVED REPORTS_XR0012385
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Entry Properties
Last modified
5/5/2020 1:41:10 PM
Creation date
5/5/2020 12:25:25 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012385
RECORD_ID
PR0545638
PE
3528
FACILITY_ID
FA0005998
FACILITY_NAME
UNION OIL SS#2859
STREET_NUMBER
1665
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95204
APN
13702031
CURRENT_STATUS
02
SITE_LOCATION
1665 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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LSauers
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EHD - Public
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Chesapeake Dive•Redwood City,CA 941415)364 9600 U 18939 1201h Ave, N E. Suite 101 •Bothell,WA 98011 •081 9200 <br /> UNO AL - <br /> U 819 Striker Ave Suite 8•Sacramento,CA 95834•(916)921 9600 IJ East i 1 1 15 Mont�omoiy Suiio D•Spukano WA 992M•(509)924 IM100 <br /> f <br /> U 404 N Wrget Lane•Walnut Creek,CA 94598•(510)988 9600 U 15055 5 W Sequoia Pkwy,Suite 110•Portland,OR 97222•(503)624 9800 <br /> Consultant Company G Project Nae� v3 Q _ a <br /> Jo <br /> Address Qd26 Ti-6 UNOCAL Project Manager '00 <br /> sr <br /> City j State C_A, Zip Code 7S\ O AFE ItLD <br /> Telephone FAX If Site If, City, State <br /> 10 <br /> Report To 1\00?-64) MJF Sam ler c QC Data.bevel D (Standard) ❑ Level C ❑ Level B ❑ Level A <br /> Turnaround WO Work Das ❑ 5 Work Das ❑ 3 Work Da °- <br /> Y Y Ys ❑ Drinking Water Anal ses Requested <br /> Time ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours Q Waste Water <br /> CODE- ❑ Misc ❑ Detect ❑ EvaE emed ❑ Demol ❑ Closure P<Iher <br /> Client Date/Time Matrix It of Cont Laboratory <br /> Sample I D Sampled Desc Coat Type Sample # Comments <br /> 2C o <br /> Q <br /> 3 <br /> 4 <br /> r <br /> 6 <br /> 7 <br /> 8 <br /> 9 <br /> iQ o <br /> m <br /> 0 <br /> I Relinquished By Date Time Received By Date Time , <br /> a> <br /> Relinquished By Date Time Received By Date Time L <br /> Relinquished By I Date lTime Received By Lab Date Time <br /> I <br /> Were Samples Received in Good Condition?ID Yes C.f No Samples on Ice? li Yes❑ No Method of Shipment Page_of <br /> To Be completed upon receipt of report , <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes IJ No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? rl Yes r'A No If no, what was the turnaround time? _ <br /> Approved by _ —-_ -_ - - _ ---- —_ ___ _ Signature m m __ --_ —_ --Company _ _ -- _ _ _ Date _ _ <br />
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