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COVWXIZZG (2)
EnvironmentalHealth
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2500 – Emergency Response Program
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COVWXIZZG (2)
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Entry Properties
Last modified
1/5/2022 11:42:36 AM
Creation date
1/5/2022 11:40:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COVWXIZZG
PE
2546
STREET_NUMBER
3603
STREET_NAME
ST ANDREWS
STREET_TYPE
DR
City
STOCKTON
Zip
95219
APN
11821011
ENTERED_DATE
3/22/2021 12:00:00 AM
SITE_LOCATION
3603 ST ANDREWS DR
RECEIVED_DATE
3/22/2021 12:00:00 AM
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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SJGOV\ymoreno
Tags
EHD - Public
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TIISVD -n <br />0 <br />CI) <br />0 <br />0 pnqs cce 606/206 5P113 0296 VO Jeey 0 <br />0 <br />NJ <br />Co 0 <br />Vi 11Received by: 11Relinquished by: 11Received by: 11Relinquished by: 11Received by: j,IV A4 11Relinquished by: lie / Signature _ II Lab ID# 11Sampler Printed: 11Sampler Signature: 11Report Attention: Alex Steele / Dave Larsen 111Proj# / PO # /Global ID: Snitj\-- At...)ozEk.,\JS (2).J9d, vd 11Phone / FAX: (209) 942-1401 liCity/State/ZIP: Stockton, CA 95204 IlAddress: 4040 West Lane Customer: PG&E Stockton \--4 .\-..) <br />a! <br />s!) <br />.1. SAMPLE ID --0 <br />CP <br />...___. <br />...1.... <br />c),Q <br />....),,, DATE 8 „....). TIME --, <br />._... <br />P <br />k....) Printed Name 0 , <br />9 <br />o N <br />13 <br />r DESCRIPTIONILOCATION SAMPLE TYPE <br />composite(c) discrete/grab(d) <br />\JA <br />-o <br />(_") <br />el ED <br />SAMPLE MATRIX <br />soil(s) liquid(I) vapor(v) other (o) <br />BTEX/MTBE/TPH-GAS 8021/8015 REQUESTED ANALYSES ---1 kJ") <br />C q <br />—I <br />g <br />TPH-DIESEL -8015 <br />TRPH 418.1M / SM5520C & F <br />..' <br />J <br />() Company Name Oxy's / EDB / DCA by 8260 <br />8260 - full list <br />\ \ <br />PCBs - 8082 <br />..,_ Electronic Deliverables (EDF) 'Turn Around Time: 24 Hour I I 48 Hour 3 Day 5 Day (Normal) Special: )<„, <br />N .._. ......, NUMBER OF CONTAINERS 1 Total number of containers submitted to the laboratory OBSERVATIONS/REMARKS 1 Z o <br />cn rNi \j <br />CD <br />C ---- <br />CI .1 <br />( Method of Shipment: CE-(
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