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CO0053822 (2)
EnvironmentalHealth
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2500 – Emergency Response Program
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CO0053822 (2)
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Entry Properties
Last modified
11/19/2024 10:19:26 AM
Creation date
3/23/2022 2:08:35 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0053822
PE
2546
STREET_NUMBER
5163
Direction
W
STREET_NAME
ELEVENTH
STREET_TYPE
ST
City
TRACY
Zip
95304
APN
25011002
ENTERED_DATE
5/21/2021 12:00:00 AM
SITE_LOCATION
5163 W 11 ST
RECEIVED_DATE
5/21/2021 12:00:00 AM
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
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CASTLE ANALYTICAL LABORATORY 04317Z ON ale0119-190 0 Acioisno JO NIVHO IIReceived by: IIRelinquished by: IReceived by: IIRelinquished by: IIReceived by: Relinquished by: Signature 1 1 <br />1 . <br />I <br />I -1 <br />1 IL Lab ID# I Sampler Printed: OPi...e LAzse.t..) IISampler Signature: IReport Attention: Alex Steeje /, Dave Larsen Proj# / PO# /Global ID: nv I Phone / FAX: (209) 942-1401 IlCity/State/ZIP: Stockton, CA 95204 IIAddress: 4040 West Lane Customer: PG&E Stockton SAMPLE ID cn 0?. <br />L) <br />cti DATE . - <br />Q, <br />. ... .---. TIME ;'--) <br />C <br />,-• <br />\ `7 <br />C., Printed Name _..., <br />-- r <br />-- 0 <br />r <br />- <br />(-- DESCRIPTION/LOCATION SAMPLE TYPE <br />composite(c) discrete/grab(d) <br />sl) 1 1-Pi SAMPLE MATRIX <br />soil(s) liquid(I) vapor(v) other (o) <br />BTEX/MTBE/TPH-GAS 8021/8015 REQUESTED ANALYSES ..... <br /> <br /> <br />TPH-DIESEL - 8015 <br />3 <br />CD TRPH 418.1M / SM5520C & F PC e Turn Around Time: 24 Hour 48 Hour I 3 Day 1 5 Day (Normal) 1 Special:_ Company Name Oxy's / EDB / DCA by 8260 <br />8260 - full list <br />\\ \ PCBs - 8082 <br />Electronic Deliverables (EDF) <br />NUMBER OF CONTAINERS r Total number of containers submitted to the laboratory I OBSERVATIONS/REMARKS II Notes: c7'-0 1.10SO-1 Method of Shipment: CGILIQUO
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