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ARCHIVED REPORTS_XR0009114
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_XR0009114
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Entry Properties
Last modified
5/6/2020 3:55:00 PM
Creation date
5/6/2020 3:36:46 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0009114
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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a Wenl�De39WaflaW W = = ! W = i <br /> Is <br /> Lab nes Rancho Cordova WIDE 2 FOR <br /> i1I�1� Phone 916/852 6600 CHAIN OF CUSTODY RECORD0 -5-268 CA 95670 <br /> C1C. <br /> JNS7RUCRUC1TIONS <br /> Fax 916/852 7292 <br /> Ship To- v o'l� G rP1 Project Name./f 'ut2,��e�v -Q�oy<>/f/1° J �- R LABORATORY USE ONLY nnatytt�'t Methods <br /> �! f �40 413 1 <br /> Address-3 0�3 ��` �CrProject Number: G 4_G 201` T G 6- O G>/ Laboratory Pro�ec t# S J 4132 Short Method <br /> Method <br /> Storage Refrigerator ID z/ t egC57 60 418 1 long Method <br /> Project Locattog- (State) '010 Storage Freezer ID 4181 Short Method <br /> 4201 <br /> Sampler Namc .� u PPL Worn in Field v 503E <br /> � C�� k ((:R e 503 1 <br /> R ut 5za 2 <br /> y / Date a Received By or Method of Shlpment/Shipment I D Date/[' a 601 <br /> Z/2-a- r r ra i rry !V <br /> & 3 y 602 <br /> Relinquished By ` rateJT t Recc d By or od Shipme nt/Shipment I D Date/Iime 6608 <br /> 5 2-� a 13 -g3 / � 610 <br /> Relinquished By Dat 1lttc Reeewed By or Method of Shipment/Shipment I D Date/Time 624 <br /> _ 625 <br /> 6015 <br /> �+ 6015 M� <br /> Sample Disposal I 4 � ❑ E]4 ❑g ❑6A �� ; Q ( T 8 <br /> Lcvel of <br /> (check one) .. _E] �,�.,, r = W211 <br /> (see Stole 2) ❑68 116C ❑6D" 6E ❑7 rn 8040 <br /> 25 Laboratory Standard ' Analysis thod {� a1 00 <br /> til` :150 <br /> E) Other v <br /> SAMPLE INFORMATION 8270 <br /> _ 6310 <br /> Acidit <br /> FURL4RORATORYUSFONf,Y Y Descnption Container(s) J �L J Alkalinity <br /> Sample ID ~' atriX Pres BTEX <br /> Lab ID Number Date Ttm� Locator Depth k Type Type Type TAT chloride <br /> CLP (see Side 2) <br /> J coo <br /> I�CtSJ -DLA/ - t coir <br /> J <br /> Conductivity <br /> z Z/ t cortosrvny <br /> } { f } J Cyyasnide <br /> rods <br /> - 7 , General Mineral <br /> 4 <br /> 7��� Hes Chromium <br /> ion Balance <br /> 5 Z Z 7Z 4L ;( t; Metals(write specific <br /> 6 7 , � 4 molal 8 method#)',, <br /> 1 Metals 6010 i <br /> Metals PP <br /> 7 � Z Z e Ll Metals Tale 22 <br /> TTLC Level <br /> 81 7 7Z Z STLC Level <br /> (see Side 2) <br /> 9 ,� Nitrate <br /> Write <br /> 10 Odor <br /> Org Lead <br /> Org Mercury <br /> Special Instructions omments G f C12 7 Z G/'7 -R [ Percent Moisture <br /> z ZContainer Types A=l"Lrte�Amber TAT(Analytical Turn Around Time) Percent Solid <br /> .- C G 'Z /n B=Brass Tube C=Cassette I =24 hours 2=48 hours Perchlorate <br /> G--Glass Jar P=Polyethylene 3=I week 4=2 weeks PH <br /> saitatas <br /> �� 4 f fit l�G7 <br /> 0--Other V=Voa Vial 0=Other Phosphorus <br /> SuHate <br /> Sulfides <br /> FOR LAW TORY USE ONLY Sample Condition Upon Receipt CI44(522 SND DOCUMENTATION AND RESULTS TO(Check°�e rCLVOA <br /> - ProjectManager/Office ` ? /t Mettalsals <br /> e <br /> - r- <br /> v❑ <br /> Client Name MDS Pesticide <br /> r . 76laf Hardness <br /> Company <br /> Total <br /> TPWG <br /> Address TSS <br /> Tur6ddy <br /> Phone FAX Speedy Total or Dissolved <br />
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