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ARCHIVED REPORTS_XR0007699
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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W
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WILSON
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1250
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2900 - Site Mitigation Program
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PR0507153
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ARCHIVED REPORTS_XR0007699
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Entry Properties
Last modified
10/8/2020 10:35:48 PM
Creation date
6/23/2020 10:29:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007699
RECORD_ID
PR0507153
PE
2950
FACILITY_ID
FA0007717
FACILITY_NAME
THRIFTY OIL #171
STREET_NUMBER
1250
Direction
N
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
11731001
CURRENT_STATUS
02
SITE_LOCATION
1250 N WILSON WAY
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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• ASSOCIATED LABORATORIE !LA <br /> 806 North Bcrtavla • Oramye CA 92868 <br /> Chain of Custody Record Phone (714) 771 6900 • Fdx (714) 538 12 <br /> Company 7-14 F7 i r f 1, i�r`— �� - PhorKrt' [t r ') ' A L Job No ` C �G l ✓ Page of <br /> Protect Managert J�tI Fax �I G 12-( <br /> (� Analysts Requested Test Instructions & Comments <br /> Protect Name ` �i Project kSite <br /> Name <br /> and <br /> Address <br /> Sample ID Lab ID Date Time Matrix Container Pres <br /> Number/Size <br /> X, <br /> 2 <br /> 3 <br /> 4 <br /> 5 <br /> 6 <br /> r <br /> 7 <br /> r <br /> 8 <br /> 9 <br /> P <br /> 10 <br /> t1 <br /> S <br /> l2 <br /> 4 <br /> 13 <br /> ti <br /> 14 <br /> 15 <br /> Sample Receipt-To Be Filled 8 LaboratoryRelinquished by 1 Relinquished b 2 Relinquished by 3 <br /> P P Y <br /> Sampler <br /> Total Number of Containers y Properly Cooled Y I N/ A Signature �r� Signature Signature <br /> Custody Seals I 1 NA Samples Inta t Y/N/NA fb*Printed Name Printed Name Printed Name Y <br /> Received in Good Conditio Y 1 Samples Accept DateZ Time �y 1 I Date Time Date Time y <br /> J( ( c C <br /> Turn Around Time Received By 1 Received By 2 Received By 3 <br /> Signature Signature Signature <br /> C 1Normal RUSK Q Same Day 1348 lira Pnnied Name Pnnted Name �� I Printed Name <br /> ❑24 hrs ❑72 hrs �A <br /> Date Time Date Time 1 -bate Time <br /> Lf <br /> r n .nn wbor I .hr +tn h,. n,nF ProiartlArrnpnt Nininsr G,- <br />
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