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COMPLIANCE INFO_2020
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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WILSON
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3210
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2200 - Hazardous Waste Program
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PR0540792
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
6/3/2020 11:32:24 AM
Creation date
6/3/2020 11:20:05 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0540792
PE
2220
FACILITY_ID
FA0023321
FACILITY_NAME
Caliber Collision Centers - Stockton
STREET_NUMBER
3210
Direction
N
STREET_NAME
WILSON
STREET_TYPE
Way
City
Stockton
Zip
95205
CURRENT_STATUS
01
SITE_LOCATION
3210 N Wilson Way
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\dsedra
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EHD - Public
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TestAmerica Irvine estAme <br /> '� ca <br /> 17461 Denan Ave Suite 100 Chain of Custody Record <br /> Irvine, CA 92614-5817 oryt 1 ; x isw 44 r it it w ;,. . •r r, . -i 6 1 <br /> Phone (949) 261 -1022 Fax (949) 260-3297 <br /> Sampler Loh PM Garner Tracking Na(s) COC No <br /> Client Information Brandon West Roberts, Danielle C �Z 7 �/ LU 02 <br /> Client Contact Phone E-Mail Page <br /> Brandon Thomas 1-Naomi Fox 800-619-97331847440-9177 danielle roberts@testamericainc.com 5T7 5 0117 Page 1 of 1 <br /> Company Job # <br /> GMG EnviroSafe Analysis Requested <br /> Address Due pats Requeated: Preservation Codes: <br /> 1658 N. Milwaukee Ave - Suite 287 119/2020 " 'l <br /> q - HCL M - Hexane <br /> City TAT Requested (days): j to <br /> too till ;it 8 it NaOH N to None <br /> Chicago C - Zn Acetate 0 it AsNaO2 <br /> D - NIAcid P - 1I <br /> State, Zip <br /> f - NaHSO4 O - Na2S03 <br /> IL <br /> F _ MeOH R - Na2S2S03 <br /> Phone PO # G - Amchlor S - H2SO4 <br /> 847-740-9177 qq", H - Ascorbic Acid T - TSP Dodecahydrate <br /> Emafiloom <br /> WO # i' 1 _ ice U - Acelone <br /> nifoX envlrosafe Com O v J to DI Water V - MCAA <br /> o K - EDTA W - ph4.5 <br /> Protect Name ProteaL - EDA Z - other (speaty) <br /> Caliber Colliston Center - Stockton 1060 & S <br /> site SSOW# : other. <br /> 3210 North Wilson Way, Stockton, CA 95205 L <br /> E o <br /> Sample Matrix 0 <br /> Type (wnra,er, Z <br /> floor <br /> Sample (C=comp, o Iwai, <br /> Sample Identification Samle Date Time G=grab) ert;rns e, Aa cal Special Instructions/Note: <br /> v it PI ' tvatioh ,Code, It t <br /> m Paint Booth Filter (TCLP testing only) 24 hr turnaround 1 /10120 8AM G S x <br /> P <br /> O <br /> 440-259162 Chain of Custod <br /> Possible Hazard tdentificadon --�-� --77 Sample Disposal ( A fee may be assessed if samples are retained longer than f month) <br /> © Non-Hazard Flammable Skin irntant Poison B [R �� <br /> rknown ';adiolo ical =] Relum To Client =Disposal By Lab Archive For Months <br /> Deliverable Requested I, 11, ill, 1V, Other (specify) Special Instructions/QC Requirements <br /> Empty Kit Relinquished by Naomi Fox jDate, 1/13/2020 Pined 4.00PM I I <br /> Method or shipment UPS Nxt Day Air <br /> Relinquished by Brandon West Dawforune 1/102020 / 2 30PM Company Received by Naomi Fox Daterrime• 1/ger2020110AM Company <br /> Caliber GMG EnviroSafe <br /> Relinquished by Noorm Fax Date(Tlme 1113120204PM Company Received by Daterrime Company <br /> N GMG EnviroSafe <br /> 475Z 1 till <br /> IN Relinquished by Date rime Companye [ Da e 7 company <br /> G 6Ar <br /> fI7 Ly <br /> 01 1 <br /> IVO Custody Seals 19KCL Custody Seal No : Cooter Te rature(s) °C and other Remarks !! <br /> 4 Yes o tq ' L1 LCt . � _ ' � <br />
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