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COZTC3OPF
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2500 – Emergency Response Program
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COZTC3OPF
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Entry Properties
Last modified
4/27/2023 4:18:09 PM
Creation date
4/27/2023 4:15:36 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
COZTC3OPF
PE
2546
STREET_NUMBER
230
Direction
W
STREET_NAME
20
STREET_TYPE
ST
City
TRACY
Zip
95376
APN
23319032
ENTERED_DATE
8/17/2022 12:00:00 AM
SITE_LOCATION
230 W 20TH ST, TRACY, CA 95376
RECEIVED_DATE
8/17/2022 12:00:00 AM
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\bmascaro
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EHD - Public
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CASTLE ANALYTICAL LABORATORY CHAIN OF CUSTODY <br />Location: 2333 Shuttle Drive, Bldg 908/909, Atwater, CA 95301 <br />Mailing Address: 2333 Shuttle Drive, Atwater, CA 95301 <br />Certificate No. 2480 <br />PAGE 1 OF <br /> <br />i,iiL4i hi iiI_ <br />Customer: PG&E Stockton SAMPLE TYPE composite(c) discrete/grab(d) SAMPLE MATRIX soil(s) liquid(I) vapor(v) other (o) REQUESTED ANALYSES NUMBER OF CONTAINERS Method of Shipment: _ ( <br />(le-Li L)(/` Address: 4040 West Lane BTEX/MTBE/TPH-GAS 8021/8015 TPH-DIESEL - 8015 TRPH 418.1M / SM5520C & F Oxy's / EDB / DCA by 8260 8260 - full list PCBs - 8082 IElectronic Deliverables (EDF) City/State/ZIP: Stockton, CA 95204 Notes: <br />2.._ H2 1-2L) 1-\ <br />Phone / FAX: (209) 942-1401 <br />Proj# / PO# /Global ID: ‘:10Uer O. LtA fL <br />Report Attention: Alex S eele,.. a Larse <br />Sampler Signature: <br />Sampler Printed: OP(X-- <br />OBSERVATIONS/REMARKS <br />Lab ID# SAMPLE ID DATE TIME DESCRIPTION/LOCATION <br />COUra-C. Or. q-10-22 %.'o5 t Oa_ 0.41_ V 1 <br />L II 1,-ILA A PL, %-I1 fl g,20 1. 02_ cD\ (-- I/ l <br />Total number of containers <br /> Signature Printed Name Date Time Company Name 2._ submitted to the laboratory <br />Relinquished by: do/ ntqUe, E--,0 Oce.. E.,,-- Turn <br />3 <br />Around Time: <br />Received by: <br />,. `6-7 <br />Y fir .a15--) Ca i47-Q 24 Hour I I <br />48 Hour I <br />Day I 1 <br />Relinquished by: <br />Received by: <br />Day (Normal) <br />V'-... Special: <br />Relinquished by: 5 <br />Received by:
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