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ARCHIVED REPORTS_XR0006773
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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Y
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YOSEMITE
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853
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2900 - Site Mitigation Program
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PR0508124
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ARCHIVED REPORTS_XR0006773
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Entry Properties
Last modified
7/27/2020 3:03:35 PM
Creation date
7/27/2020 2:22:30 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006773
RECORD_ID
PR0508124
PE
2950
FACILITY_ID
FA0007949
FACILITY_NAME
7 ELEVEN #21756
STREET_NUMBER
853
Direction
E
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
22332015
CURRENT_STATUS
01
SITE_LOCATION
853 E YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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• 0 <br /> Chain of Custody Number- -- LI 9 <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento El <br /> Additional documents are attached,and are part of this Record <br /> Address 3017 Kilgore Road,Suite 100 Job Name 7-Eleven Store#21756 <br /> Rancho Cordova,CA Location 853 East Yosemite Avenue <br /> Manteca,CA <br /> Project# 77EL 21756 03 Task# 0410 Analysis Request <br /> Project Manager Jaff Auchterlonie <br /> 0 <br /> Laboratory Kiff Analytical <br /> Turnaround Time Standard a m <br /> ua+ Q aro3 0 �g c <br /> 1.- .9 <br /> U n m c3 C <br /> Sampler's Name Tom Mill ca8 a m <br /> Sampler's Signature g£ � N <br /> Sample ID Date Time Matrix HCI r E E "' a Cammentsl <br /> p i o � > (0 z ct m Instructions z' <br /> rMAylF* aWwttrr <br /> Water <br /> -'VYeleE <br /> MW-4 ! a 416 / 60 water x X X 3 O S <br /> EL <br /> Special Instructions/Comments Relinquished b Received by Sample Receipt <br /> 5 Oxygenates TAME, MtBE,EtBE,TBA,DIPE Sin s Sign Total no of containers <br /> Global ID#T0607700549(SIRC) Print Print Chain of custody seals <br /> EDF Deliverables(email EDF to dcatlin@secor com) CompanyCompany Recd in good condihonlcold <br /> email lab report to dhersog@secor com Time DateTi Date Conforms to record <br /> Relinquished by Receiv by <br /> Sign Sign Client SECOR <br /> Print Print WN Client Contact Brian Care <br /> Compo Company t 'Client Phone (916)861-MO <br /> Date Time leo Date ext 241 <br /> 16 SECOR CUSTREC Rei Z= <br /> Date 4�2/ ,e� Page or <br />
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