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CO9ACHSRY (2)
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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SEXTON
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21915
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2500 – Emergency Response Program
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CO9ACHSRY (2)
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Entry Properties
Last modified
4/27/2021 2:33:39 PM
Creation date
4/27/2021 11:45:38 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO9ACHSRY
PE
2546
FACILITY_NAME
PRIVATE PROPERTY
STREET_NUMBER
21915
STREET_NAME
SEXTON
STREET_TYPE
RD
City
ESCALON
Zip
95320
APN
24525025
ENTERED_DATE
12/30/2020 12:00:00 AM
SITE_LOCATION
21915 SEXTON RD
RECEIVED_DATE
12/30/2020 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\ymoreno
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EHD - Public
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CASTLE ANALYTICAL LABORATORY <br />PS"-2_2_ 2 / <br />CHAIN OF CUSTODY <br />Location: 2333 Shuttle Drive, Bldg 908/909, Atwater, CA 95301 <br />Mailing Address: 2333 Shuttle Drive, Atwater, CA 95301 <br />Phone: 209 384-2930 - Fax: 209 500-1848 <br />ELAP Certificate No. 2480 <br />PAGE <br /> <br />OF <br /> <br />Customer: 9-t If- C SAMPLE TYPE composite(c) discrete/grab(d) SAMPLE MATRIX soil(s) liquid(I) vapor(v) other (o) REQUESTED ANALYSES NUMBER OF CONTAINERS II Method of Shipment: <br />Address: El ( 1.%) 7- BTEX/MTBE/TPH-GAS 8021/8015 1 TPH-DIESEL / MOTOR OIL - 801581 TRPH 418.1M / SM5520C & F Oxy's / EDB / DCA by 8260 8260 Volatiles- full list 1- PCBs - 8082 Electronic Deliverables (EDF) City/State/ZIP: 004-014toe- Notes: <br />CL (t Q <br />'QO / - I .)- ) <br />..- 4 Phone / Email: afey S gese...„,c.‘ei -.X i2ii1,4 - ..,e- "IL- <br />Project# / PO# / Global ID: <br />Report Attention: <br />Sampler Signature: <br />Sampler Printed: <br />Lab ID# SAMPLE ID DATE TIME DESCRIPTION/LOCATION OBSERVATIONS/REMARKS <br />17 A 0515214 1 q24° 2411r SexTPAI Cer-erkcol 4._ <br />11414)0111 <br />, <br />_ <br />Signature Printed Name Date Time Company Name <br />Total number of containers <br />submitted to the laboratory <br />- r- Relinquished py: (7674 A , Te-11-45 iu 2$ Turn <br />24 <br />48 <br />3 <br />5 <br />Around Time <br />Received by: '- , <br />Vdio <br />;i:-i1-.e.,- Hour <br />Relinquished by: Hour I <br />Received by: Day I <br />Relinquished by: Day (Normal I <br />Received by: Speci . •
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