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CO0055813
EnvironmentalHealth
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26 (STATE ROUTE 26)
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5424
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2500 – Emergency Response Program
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CO0055813
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Entry Properties
Last modified
11/20/2024 8:49:40 AM
Creation date
7/11/2023 1:19:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2500 – Emergency Response Program
RECORD_ID
CO0055813
PE
2546
FACILITY_NAME
AGUILERA, JUAN Y
STREET_NUMBER
5424
Direction
E
STREET_NAME
STATE ROUTE 26
City
STOCKTON
Zip
95215
APN
10104003
ENTERED_DATE
5/1/2023 12:00:00 AM
SITE_LOCATION
5424 E HWY 26
RECEIVED_DATE
5/1/2023 12:00:00 AM
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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SJGOV\bmascaro
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EHD - Public
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CASTLE ANALYTICAL LABORATORY <br />Location: 2333 Shuttle Drive, Bldg 908/909, Atwater, CA 95301 <br />Mailing Address: 2333 Shuttle Drive, Atwater, CA 95301 <br /> <br />O. 50.s-Lic)2.-7 <br />Certificate No. 2480 <br /> <br />CHAIN OF CUSTODY <br />PAGE OF <br /> <br />ri lui IC. kz.u) ,p-p-r-cov - I an <br />Customer PG&E Stockton SAMPLE TYPE composite(c) discrete/grab(d) SAMPLE MATRIX soil(s) liquid(I) vapor(v),. other (01 REQUESTED ANALYSES NUMBER OF CONTAINERS Method of Shipment: A <br />Address: 4040 West Lane BTEX/MTBE/TPH-GAS 8021/8015 TPH-DIESEL - 8015 TRPH 418 1M / SM55200 & F Oxy's / EDB / DCA by 8260 8260 - full list PCBs - 8082 Electronic Deliverables (EDF) City/State/ZIP: Stockton, CA 95204 Notes: <br />1 t--14-2 C2L) Phone / FAX: (209) 942-1401 <br />Proj# / PO# /Global ID: 9-174 ttL,) --a( , <br />Report Attention: Alex Steele 'Da Larsen <br />Sampler Signature: <br />Sampler Printed: Oto,.0t..t.17 (...,P\c2S) <br />Lab ID# SAMPLE ID DATE TIME DESCRIPTION/LOCATION OBSERVATIONS/REMARKS <br />5-1 -73 00 \O2 0, L._ c./ I <br />ignature Printed Name Date Time Company Name I <br />Total number of containers <br />submitted to the laboratory <br />Relinquished by: "ad-o-iii/t541,---- Dave Larsen 5-i-23 3'.1-5- PG&E Turn <br />24 <br />Around Time: <br />._ <br />_ <br />Hour Eli Received bci7 <br />Relinquish (j 48 Hour I I <br />Day <br />Day (Normal) I <br />Received by: 3 <br />Relinquished by: 5 <br />Special: 1 1-\-2.. 1-1L-.) \-1 Received by:
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