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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
Scanner
LSauers
Tags
EHD - Public
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mertW083Wa4,a the �, <br /> iLab ries Rancho Cordova IDC 2 I-OR <br /> PCA 95670COMPLhone 916/852-6600 CHAIN OF CUSTODY RECORD 03265 INS7RUC ONS <br /> Fax 916/852-7292 <br /> //►�'//� FOR LABORATORY USE ONLY common z <br /> G A ISO 4,011,CJ Project Name: 64, elm 4131 cal Methods <br /> Ship To• � <br /> �{U S 413 1 <br /> p �¢ [ G 0 4-a 20 yp G�0 00/ Laboratory Pro jftt# v 4132 Long Method <br /> Address Project Number 4132 short Method ,T <br /> } Storage Refrigerator iD4,Y- X- �H�s%60 4 18 1 Long Method .1 <br /> , Cf�C 4O Co�r�yQ Project Location: (Sia ) �� Storage Freezer ID � 4201 Short Method <br /> S31a ler Name ure RPh Wort in field 5032 <br /> / � 553E � <br /> T��C/ C//1�a '/ f ��f/ �I t e r�. - C/ 524 2 ✓ <br /> Re�m�unhed By EF3to a Received B or Me od of Shipment/Shipment I D Date/T601 <br /> 604 <br /> Relinqyisped By oPte/itrn� / 7 Re cdBy o M od of hipment/Shlpment I D ; Date J 608 <br /> 610 4 <br /> Relmqui he y �Dates/I-ime f /• Received By or Method of Shipment/Shipment I D Date/f une 625 <br /> 8010 <br /> 8o 15 <br /> 15 <br /> Sample Disposal X] 1 L]2 ❑3 ❑4 ❑s ❑6A ANALYSES REQUESTED am Mad <br /> (check one) Level of QC 8021 <br /> (sec$1de 2) <br /> E]613 E]6C W❑6D ❑6E ❑7 nte in ao�80 <br /> Laboratory Standard Analysts Method �` 6150 <br /> ❑ Other SAMPLE INFORMATION w8150 <br /> elm <br /> 1 . 8310 <br /> �/1 Acidity <br /> Descrt lionAlkahndy <br /> BTEx <br /> FOR LABORATORY USF ON!Y Contatner(s) <br /> Sample ID Matrix Pres Chloride <br /> Lab ID Number Date Time Locator Depth # Type Type Type TAT 6coo{ See Side 21 <br /> 1`go-l/0 a 53 Color <br /> Conductivity <br /> Corrosrvtly <br /> 2 / Cyanide <br /> 3 � G Fluuooridenl Sr7t <br /> General <br /> Mineral,r <br /> 4L3 22 Hex Chromium <br /> Mn Balance <br /> 5 f Metals(write spealic <br /> metal d method sl <br /> 5 3 �'j Metals 6010 <br /> Metals PP <br /> Metals Title 22 <br /> TTLC Level <br /> g STT Le el <br /> NArale <br /> 9 Nrtrne <br /> Odor <br /> 10 Org Lead <br /> Org Mercury <br /> $ cial Inst ctions/CommentsPercent Moisture <br /> Pe O r� E� 1-3 Container Types A=1 Liter Amber TAT(Analytical Turn Around Time) Percent Selyd <br /> � / -400(2 �- ��JC P v e /',-7 I B=Brass Tube C=Cassette 1 =24 hours 2=48 hours pH lorate <br /> 41 e G=Glass Jar P=Polyethylene 3=1 week 4=2 weeks Phosphates <br /> 0--Other V=Voa Vial 0=Other shl chorus <br /> Sulfides <br /> TCLP <br /> FOR L413O,�1TORY USE ONLY Sample Condition Upon ReceiptSAIh SEND DOCUMENTATION AND RgSULTS TO CCheglyone) VOA <br /> Semw <br /> 1N. ¢'� <br /> ;a Pesticide Manager/Of ce _ �lrl� �`f_01 0 Metal s <br /> Pesticide <br /> ❑ Client Name ros <br /> Total Hardness <br /> Total Solids <br /> Company TPHlD <br /> TPHlG <br /> Address G e TSS <br /> Turbdtty <br /> Phone FAX specify Totat or DissoMed <br />
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