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CO0054426 (2)
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2500 – Emergency Response Program
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CO0054426 (2)
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Entry Properties
Last modified
4/4/2023 2:16:22 PM
Creation date
4/4/2023 2:10:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0054426
PE
2546
STREET_NUMBER
29050
Direction
E
STREET_NAME
WIMER
STREET_TYPE
RD
City
LINDEN
Zip
95236
APN
06728010
ENTERED_DATE
11/8/2021 12:00:00 AM
SITE_LOCATION
29050 E WIMER RD
RECEIVED_DATE
11/8/2021 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\ymoreno
Tags
EHD - Public
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29050 E Wimer Rd, Linden <br />11/23/2021 <br />Photo 5: Page two of Chain of Custody. <br />icORATcR <br />P:.13'731aNttl rve. .111d9 908/90. Atwater, CA 95301 <br />Phone. (209) 384-2930 - Fax: (209) 500-1848 <br />Record ID 000054426 <br />ER Complaint <br />PAGE OF 3 <br />Icustomer: f±{(6_,i s SAMPLE TYPE composite(c) chscretergrab(d) SAMPLE MATRIX soll(s) fiquid(1) vapor(v) other (o) REQUESTED ANALYSES NUMBER OF CONTAINERS Method of Shipment' iAddress: --2, -roink. Eaza312LLS. BTEXAATBE/TPH-GAS 802118015 TPH-DIESEL / MOTOR OIL - 80158 TRPH 418 1M I SM5520C & F Oxy's I EDB / DCA by 8260 8260 Volatiles- full list I PCBs- 8082 i 6y <br />0 <br />.. <br />. a <br />City/State/ZIP: cazo (4,i s 0}..,;.S0 o ) CA 93401 Notes: <br />e roults <br />L., c <br />Phone / Email: 510— 1p c(7-- <br />"roject# / PO# (Global ID: 3() /10/1 c jilM'- 1114 r hins et oxotel4s,Cern <br />ort Attention: jy-pkv 6,4 (a, 0.,,, (, .1em L4 11 rtimani arreuk Leyvt <br />_ „II* er Signature: <br />.,,,--tr Printed: 10,(5t tf C\ vnY1,9// k-C16,141 ri.ie_y <br />SAMPLE ID DATE TIME DESCRIPTION1LOCATION OBSERVATIONS/REMARKS <br />1)4 11/23A1 10.* 54 [ALI/ied' /a D 5 XX <br />IL. ik I> c> K X <br />f 10 ..49 I) S <br />E3, it.,25 D 5 <br />10 :4c( <br />a lido D <br />i--- .3s ..(5. Jo : 16 D \ <br />DoP I au 0 5 X <br />12_2 <br />• D S <br />Total number ol containers <br />Date Time Company Name submitted to tne laboratory <br />Signature Printed Name <br />Turn Around Time: <br />&in.:wished try: 24 Hour IN <br />- by: ecerred 48 Hour /1EI <br />by: 3 Day OM <br />- eli .uished <br />5 Day (Normal) MI Ned b <br /> • b Special: <br />1.____L.._.--r5hed <br />John Alaniz, REHS Page 5 of 7
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