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COMWIYNAR
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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CLAY
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2500 – Emergency Response Program
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COMWIYNAR
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Entry Properties
Last modified
4/27/2023 4:19:20 PM
Creation date
4/27/2023 4:01:52 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COMWIYNAR
PE
2546
STREET_NUMBER
611
Direction
E
STREET_NAME
CLAY
STREET_TYPE
ST
City
STOCKTON
Zip
95206
APN
14727046
ENTERED_DATE
8/20/2022 12:00:00 AM
SITE_LOCATION
611 E CLAY ST, STOCKTON, CA 95206
RECEIVED_DATE
8/20/2022 12:00:00 AM
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\bmascaro
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EHD - Public
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SVU. <br />CASTLE ANALYTICAL LABORATORY <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 />Certificate No. 2480 <br />PAGE t OF <br /> <br />Customer: PG&E Stockton SAMPLE TYPE composite(c) discrete/grab(d) SAMPLE MATRIX soil(s) liquid()) vapor(v) other (o) 1 REQUESTED ANALYSES NUMBER OF CONTAINERS Method of Shipment: i <br />Address: 4040 West Lane BTEX/MTBE/TPH-GAS 8021/8015 TPH-DIESEL - 8015 TRPH 418.1M / SM5520C & F Oxys / EDB / DCA by 8260 8260 - full list PCBs - 8082 Electronic Deliverables (EDF) City/State/ZIP: Stockton, CA 95204 Notes: <br />t3,1 OA or4liv <br />Phone! FAX: (209) 942-1401 <br />Proj# / PO# /Global ID: (4 .--4 ( (-13-1 s--\-- <br />Report Attention: Alex eelei/ a Larsen <br />Sampler Signature: <br />Sampler Printed: Printed: rDp\v jr- F\ QS eL._) <br />Lab ID# SAMPLE ID DATE TIME DESCRIPTION/LOCATION OBSERVATIONS/REMARKS <br />E , CUni S-2,a7a'T. I 02 <br />Signature Printed Name Date Time Name <br />i <br />I <br />Total number of containers <br />submitted to the laboratory <br />Relinquished by: ,1/61(.---- .7 413A L.P.42SE.k..) c62c).22_ <br />aripany e : . - -, Turn <br />24 <br />48 <br />3 <br />5 <br />Around Time: <br />Received by: -s-,....y..-r.3; )--z.7 Fc'--e- ;)c-,--,,-A-1_7 g..z.z.-).2. 7 r1)-12 Hour <br />Relinquished by. by: Hour <br />Received by: Day I <br />Relinquished by: <br />Special: <br />Day (Normal) I i <br />Received by:
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