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ARCHIVED REPORTS_XR0012397
EnvironmentalHealth
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1665
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3500 - Local Oversight Program
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PR0545638
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ARCHIVED REPORTS_XR0012397
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Entry Properties
Last modified
5/5/2020 1:14:37 PM
Creation date
5/5/2020 12:47:06 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012397
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
Tags
EHD - Public
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U 660 Chesapeake Diive•Redwood City,GA 94063•(it I x).361 91jui) U 1693y I Guth Ave,N L,5uile til l •Bothell,YVA :31st111 •%,W)4b i bse-W <br /> ❑ 819 Striker Ave,Suite S•Sacramento,CA 95©36)921 9600 U East 11115 Montgornery,Suite B•Spokane,WA 99206• 9)924-9200 z <br /> UN O@A L (D p 404N Wiget Lane•Walnut Creek,CA 94598•(5989 9600 U 15055 5 W Sequoia Pkwy,Sude 11D•Portland,OR 9 }ta"24-9800 <br /> Consultant Company Project Name 012 EP, 0NocQL- S <br /> P Y G ESL �!i- R t .... .�N� 10 <br /> Address' <br /> I <br /> -+ * s i � �r+ -� 'S I1 UNOCAL Project Manager Mr 1jo b Bov,+ <br /> , <br /> City. Dob kt% State Ztp Code qtlAFE # <br /> 9903291 <br /> -- site #, Cit State <br /> Telephone- Z r SS ��� FAX # z� 5'3'!- y� <br /> L. Sam ler 1/a'g / �.4 CSC Data 1:1 Level D (Standard) ❑ Level C ❑ Level B ❑ Level A ` <br /> Re ort To. r.Aa r��� <br /> Turnaround JA 10 Work Days OS Work Days ❑ 3 Work Days ❑ Drinking Water J lAnalyses Requested <br /> Time: ® 2 Work Das 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Mise ❑ Detect LJEval ❑ Remed Q Demol ❑ Closure ❑ Oiher � <br /> Client DatelTlme Matrix # of Cont Laboratory Comments <br /> Sample l D Sampled Dese Cont Type Sample # �Q <br /> 1. To _ LS . 3 0 1 V&h- 031233 ode 4 hr, <br /> z. _ •, /r:3 ghly '� 3 -� 9031234 -TAT ° <br /> a. �l{W_S, /p 3a 90312-35 <br /> 9031236 <br /> 4. <br /> 03123r- <br /> 4. j�l1,J ,4 9,I3 w 03123 X <br /> 5 . 8 • 9,rrL/h�, 7 3 903123' X <br /> s Mw.. } ., l�f n�J 3 9 312: 8 <br /> T. <br /> 8. <br /> 9 <br /> 10 <br /> Relinquished By Date / Z22 Time �;`fTTeceived By Date 3- /2 Time 17&6 <br /> Relinquished By Date Ttm C1`C} Received B Date Time <br /> Date Time Received 13 Lab Date Time <br /> Retia uished B 3 <br /> Were Samples Received In Good Condition?Q Yes E) No Samples on Ice? a Yes U No Method Shlpme Page o _ <br /> To be competed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? G Yes Q No If no, what analyses are still needed? <br /> 2) Was the report issued within the requested turnaround time? ❑Yes❑ No If no, what was the turnaround time? <br /> Annroved by _- -_—_-- - --- Signature _ Y- - Company -___-- Date' <br />
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