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COMPLIANCE INFO_2015-2016
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2300 - Underground Storage Tank Program
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PR0232534
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COMPLIANCE INFO_2015-2016
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Last modified
11/19/2024 10:19:32 AM
Creation date
6/3/2020 9:57:57 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2015-2016
RECORD_ID
PR0232534
PE
2361
FACILITY_ID
FA0004547
FACILITY_NAME
CHEVRON STATION #201383
STREET_NUMBER
1960
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
23402001
CURRENT_STATUS
01
SITE_LOCATION
1960 W ELEVENTH ST
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
KBlackwell
Supplemental fields
FilePath
\MIGRATIONS\E\ELEVENTH\1960\PR0232534\RETROFIT 2015.PDF
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EHD - Public
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N McCarn.pbe(I Analytical, Inc. <br />CHAIN OF CUSTODY RECORD <br />0* 1534 Willow Pass Rd. / Pittsburg, CA 94565-1701;' , <br />�tQUIYb TIME: Izusrt I unv [Al z onv [:JJ 3 unv ( s DAY <br />www.mccampbell,com / mainCmccampbell.com <br />Telephone: (877) 252-9262 / Fax: (925) 252-9269 <br />,eo r<o cf. 1 Di❑ PDP pr GDD Write On (DW) [ r_Quls Q1 env <br />Unuent Sit fitple Req uh-Ing a',I" 11ag0 uS'I'Cle:s» ulr hunt) Project Q; Clniul iI <br />ReIL(, v: ({iersten 1loelr hill Tv: Gill) -Kiersten ltoey <br />Anal <br />psis Re(] nest <br />cvtlipauy: <br />U <br />5900 Mollis St, Suite A, Emeryville, CA 94608 <br />— <br />Tele: ( 510 420-3347 E-Mail: Kiersten-hoey rr,ghd.coin <br />---�_-- <br />Prvjecl #: 11103471�Prv'ect Nante: Chevron 201383 <br />Prvjecl Location: 1930111. 11"' S(,'I racy, CA Purchase Ordei-H 34004571 <br />n <br />d <br />Sampler Signature: <br />SANI['LING <br />MATRIX <br />MET110D <br />PRESERVED� <br />rya, <br />W <br />G <br />G <br />u <br />rr <br />t`•r <br />8 <br />R <br />c' <br />s <br />s <br />ry <br />r u <br />`'C <br />5,111.11 1,1; IIJ <br />Locnliou/ <br />°3 <br />p <br />E <br />E <br />�_ <br />" <br />v <br />'; <br />¢ <br />oo <br />r <br />eo <br />n <br />C <br />5 <br />0 <br />Q <br />E <br />J <br />< <br />< <br />C9 <br />Field Poilll <br />Name <br />Dale <br />Titne <br />o <br />e <br />n <br />'n <br />in <br />n <br />V <br />^ <br />O <br />G <br />C <br />n <br />v: <br />n <br />n <br />n <br />n <br />» <br />t <br />rn <br />O <br />S <br />is <br />F <br />E'- <br />- <br />w <br />w <br />w <br />w <br />W <br />w <br />u <br />-II- <br />X <br />h <br />� <br />"MAI cllenls MUST dhefose any dmrgeroos ch'?nilcals known fo be present In their submilled samples In concenlrallons Thal may cause Immedlafe harm or seilaus future health endangerment as a tesull of brief, gloved, open oomple <br />handling by MAI slolf. tlon•di,closure Incurs an Innn�dfoh $250 surcharpe and the ellen, Is subject to full legal liability tot harm suffered. Thank you lot your understanding and for allowing us Io work safely. <br />"' 11 metals are requested for water tnpIe_LWid Ilse violet Type Is not specified on the chain of custody, then MAI will default to metals by E200.0. 6 Z <br />Rciingnrshed Iiy <br />µ <br />Dole: <br />T'fole: <br />Received 3 <br />ICI /1 COMMENTS: _ — <br />�6 <br />�6 <br />GOOD CONDITION rr <br />In2_� - <br />! <br />�'o <br />---- <br />HEAD SPACE ABSENT <br />DECIII,ORINATED IN LAB <br />Rcliogprshed lir: <br />D te: <br />'Dime: <br />Ilcceht <br />APPROPRIATE CONTAINERS all <br />PRESERVED IN LAB <br />VOAS OSC METALSUI'IIER IIA'I.,ARDOl1S: nZ <br />Rcliaguislred By: <br />Date: <br />1'1111e: <br />Received Ry: <br />PRESERVATION <br />s <br />0 <br />M <br />M <br />C <br />M <br />FT <br />r <br />Page 13 of 14 <br />
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