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ARCHIVED REPORTS_XR0005724 CASE 2
EnvironmentalHealth
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2900 - Site Mitigation Program
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PR0545951
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ARCHIVED REPORTS_XR0005724 CASE 2
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Entry Properties
Last modified
9/24/2020 12:21:26 AM
Creation date
8/6/2020 11:28:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005724 CASE 2
RECORD_ID
PR0545951
PE
3528
FACILITY_ID
FA0003612
FACILITY_NAME
Yosemite Avenue Arco AmPm
STREET_NUMBER
1711
Direction
E
STREET_NAME
YOSEMITE
STREET_TYPE
Ave
City
Manteca
Zip
95336
CURRENT_STATUS
02
SITE_LOCATION
1711 E Yosemite Ave
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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i . • • <br /> I - <br /> SEQUOIA ANALYTICAL SAMPLE RECEIPT LOG <br /> CLIEN I NAME, � — DATE Received at Lab (Drinking eater) foi <br /> 1tk BY (PILIN€') TIME Received at Lab- regulatory put poses. YESINO <br /> All 011KOitDEit ]UUi LOG IN DAZE- (Wastervateii) for <br /> regulatory ptulroses, YESIN(l <br /> CMCLE I HE APPROPRIATE RLSPONSE LAB SAMPLE DATE <br /> SAMPLE# # CLIEN r ID DESCRIP PION MATRIX SAIYP4ED CONDI I-ION(ETC-) <br /> I (ustotl)' SWIt S) Preset 1 bsen 1; <br /> Intact/Broken* <br /> 2 Cham-of-Ct}slody ie t 1 Absent* <br /> 3 1 1,1H IL,R(,pol is 01 <br /> PAL III L Tst _ Picsc��t bsen <br /> 4 Ambill Attbtll l Sticker L <br /> Present <br /> S Aijbtll4 <br /> 0 Sample Llbuls tcsc /Abscnt <br /> 7 S,unple II)s este Nal Lisled <br /> au Charts-of-Custod <br /> ri S,ltuple C0r►tlttton Bioken*/ <br /> Lcal,t t1 <br /> 9 Does tnfornt,ltlon on 010) <br /> cu�lotly rcpotts, t<<i11ic € <br /> tc,poils anti 5,11111tle <br /> l,ibcNogtcu; /No* <br /> ]t) Sa1111)lc 112c.utN%L1 JV1111ltr <br /> hold 0111c 'e No* <br /> I I 1'top-r Plescil"Il (.s T <br /> Itself Yes V No* <br /> IZ lemp 11c.c al Lab <br /> (Acu-plana range lot s.tmples <br /> EI n�im 1l Pics 41.1-2°Cry-;)No* <br /> if Ctt cleat, contact Ptoject Nlaiiaget and attach r eco d of resolution. v, 1 <br /> Sample Receipt Log <br /> Revision 21 (11110100) i, <br /> Replaces Revision 2{1110610th) Page O( <br />
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