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ARCHIVED REPORTS_XR0005727 CASE 2
EnvironmentalHealth
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2900 - Site Mitigation Program
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PR0545951
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ARCHIVED REPORTS_XR0005727 CASE 2
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Entry Properties
Last modified
9/24/2020 12:51:53 AM
Creation date
8/6/2020 11:29:39 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0005727 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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LSauers
Tags
EHD - Public
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I-- J, <br /> Work Authorization No. 288 Chain of Custody Page 2 of 2 <br /> ARCO Faailty Nv City,State(FReni) Prole nager(Consultant) Project No (Consultant) Laboratory Name <br /> 133 2908 Ben amen holt Dr, Stockton,CA Ru Benkos 776P 52133 00 0050 <br /> ARCO Engineer ARCO Telephone No S uvea <br /> p Telephone No (Consultant) Fax No (Consultant) Global ID <br /> Paul SU le-RAT 9 925 299 8891 916 861 0400 <br /> Consultant Company 916 661 0430 70607700002 <br /> Consultant Address Method of Shipment <br /> SECOR-SIRC 3017 Kilgore Rd,Ste 100,Rancho Cordova,CA 95670 <br /> Matrix Prsv <br /> Special Detection <br /> Limit(Reporting <br /> � m <br /> N <br /> r E y <br /> •. N <br /> z LU <br /> Q to Q E C w h < C r <br /> m _ <br /> CL o 'a m Q E F* <br /> m C U c 0 9 D F:- a <br /> E ° o aIM <br /> Cl) _j Z I co <br /> 0) <br /> MW-2 xx x x <br /> MW-3 x x10 Special QA/QC <br /> MW-4 x x 49 x z 10 <br /> MW-5 10 Sub'd COC Attch'd <br /> x x ! o x x 10 <br /> acts 1 x x o2 x x <br /> 10 <br /> rn <br /> a <br /> w <br /> Q <br /> ample Received Intact: Yes No <br /> Temperature received Ice No ice <br /> leli q by sa pler I &P Name) Date Time <br /> Received Sign&Print e) 7Y—71FrLab Work No <br /> 144* Q�✓jw✓ $ <br />�elinquished by Date Time Received by b:2 r3 � <br /> elinqulshGd by Date Time Received by laboratory Date Time <br /> Rev 11/29/95 <br />
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