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ARCHIVED REPORTS_XR0009107
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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P
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PERSHING
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4555
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3500 - Local Oversight Program
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PR0545652
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ARCHIVED REPORTS_XR0009107
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Entry Properties
Last modified
5/6/2020 3:58:08 PM
Creation date
5/6/2020 3:35:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0009107
RECORD_ID
PR0545652
PE
3528
FACILITY_ID
FA0003638
FACILITY_NAME
JEMCO VENETIAN CARDLOCK
STREET_NUMBER
4555
Direction
N
STREET_NAME
PERSHING
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
11017001
CURRENT_STATUS
02
SITE_LOCATION
4555 N PERSHING AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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LSauers
Tags
EHD - Public
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M vlronmentaf 3083 Gold Canal Drive t <br /> Lab ratones_ Rancho Cordova E SIDE 2 FOR <br /> CA 9567° CHAIN OF CUSTODY RECORD © 5 2 8 S COMPLETE <br /> Phone 9161852-6600 INSTRUCTIONS <br /> Fax 9161852-7292 �7 <br /> • I"I�/ ,!,r �pY/HCl Project Name: `►� n,� FOR LABORATORY USE ONLY Common <br /> Ship To. _ . ! Analytical Methods <br /> -�U rl O (-G Ct � Project Number: 0 y'd ?-0/ 4 0 6- 00/ Laboratory Project# s4,a, <br /> 4132 Long Method <br /> 413 2 Shod Method <br /> Address: ll Storage Refrigerator ID 4181 Long Method <br /> (o� y _ Project Location: (State) C Storage Freezer ID 42011 Method <br /> It W2-2 <br /> Sampler N am e tur� PPE Worn to Field � <br /> k <br /> 5242 <br /> ROW ga ime Received By or d o i phipment I D Dat a 601 <br /> r G 'Z&I f( � s , 0,7 �/?7 / & fC, / > T— J602 <br /> 604 <br /> Reltqutshed By �y Date/rune Recttved shod of S <br /> ((�J D ee 610 <br /> Relinquished By DatelTime Received By or Method of Shipment/Shipment I D Datefrime 629 <br /> 8010 <br /> 8015 ` <br /> Sample Disposal �J 1 ❑2 ❑3 ❑4 ❑5 ❑6A ANALYSES REQUESTED a015 m <br /> (check one) am Mad <br /> Level of QC W21 <br /> (see Side 2) ❑6B ❑6C ❑6D ❑6E ❑7 Write in BM <br /> Laboratory Standard Analysts Method (.� 81550 t <br /> ❑ other <br /> SAMPLE INFORMATION Q 8270 <br /> Acro <br /> Description Container(s) Q N\ sTEx''r <br /> FOR LABORATORY USE ONLY Sample ID Mautx Pres a <br /> Lab ID Number Date Time Locator Depth # Type Type Type TAT co Sidle 2) <br /> 1 sI -60 ?— r-3Z-75' Y3 Al /v(Wr 1vGfe6 lil.,7 e 3 1,X Color <br /> Conductivity <br /> 2 2-Z 7 z Cyanide <br /> Flashpoint <br /> 3 Z Z `] j f C x Fluorde <br /> 4 al <br /> ZZ z 7f Hex Chroral mern, <br /> Hex Chrorrzum <br /> Ian Balance <br /> 5 z 7 Z Metals(write speciha <br /> meta{b method R) <br /> 6 Z Z 7 �0 Metals Wl0 <br /> J Metals PP <br /> 7 G.S z r/ ' Metals Title 22 <br /> ( ! TTLC Level <br /> S <br /> 8 Z 3 Z n- 1V sSTLC Leve) <br /> eeSide 2 <br /> Nara% <br /> 9 Narde <br /> Odor <br /> 10 Org Lead <br /> � ` Oro Mercury <br /> Y O y l Q a t Z z- Fr p/7Percent Moisture <br /> Special Instru�ti /C E— CJ Contatner Types A=1 Liter Amber TAT(Analytical Turn Around Tune) Percent Sold <br /> Z C. Z. ' rf j [e Q �' �'f(/ I/� t� a/T B=Brass Tube C�assetie 1=24 hours 2=48 hours Perchlorate <br /> G--Glass Jar P=Polyethylene 3=1 week 4=2 weeks Phosphates <br /> e GG f a-( J1501R= O--Other V=Voa Vial 0=Other Phosphorus <br /> Sulfate <br /> r Sulfides <br /> N1 [Ggr9R�f' SEND DOCUMENTATION AND RESULT (C�k on, TCLVOA <br /> FOR LABORATORY USE ONLY ample Condition Upon Receipt G,n! ` G SefriNea <br /> Project Manager/Office 72 CZ - Metals <br /> Pesticide <br /> ❑ Client Name TDS <br /> Taal Hardness <br /> ,o ToWd Solds <br /> Company -�/ ? Lt-"' L Q TPWD <br /> TPWG <br /> Address TSS <br /> Turbidity <br /> Phone. FAX Specify Twat or Dissolved <br />
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