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COMPLIANCE INFO 2014 - 2015
Environmental Health - Public
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2300 - Underground Storage Tank Program
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PR0516526
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COMPLIANCE INFO 2014 - 2015
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Last modified
5/28/2019 11:15:30 AM
Creation date
10/19/2018 3:11:55 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO 2014 - 2015
FileName_PostFix
2014 - 2015
RECORD_ID
PR0516526
PE
2361
FACILITY_ID
FA0012659
FACILITY_NAME
LOVE'S COUNTRY STORES OF CALIF #223
STREET_NUMBER
1553
STREET_NAME
COLONY
STREET_TYPE
RD
City
RIPON
Zip
95366
APN
24534024
CURRENT_STATUS
01
SITE_LOCATION
1553 COLONY RD
P_LOCATION
05
P_DISTRICT
005
QC Status
Approved
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KBlackwell
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EHD - Public
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Advanced GeoEnvironmental, Inc. www.advgeoenv.com <br />CHAIN OF CUSTODY RECORD <br />837 Shaw Road, Stockton, California 95215 • Phone (209) 467-1006 • Fax (209) 467-1118 nn <br />V 5 Q <br />Date: — -/q Page of <br />381 Thor Place, Brea, California 92821 • Phone (714) 529-0200 • Fax (714) 529-0203 <br />❑ 2318 Fourth Street, Santa Rosa California 95404 N, Phone (707) 570-1418 •Fax (707) 570-1461 <br />Analysis Required <br />❑ 395 Del Monte Center, #111, Monterey, California 93940 • Phone (800) 511-9300 • Fax (831) 394-5979 <br />Project Name <br />T <br />Projectna <br />v <br />,& <br />Client <br />Sampler (initials & signature) <br />IkL <br />Invoice to: AGE <br />11Client Lab Project No.: <br />Sample ID/Locatton/Description Date Time Matra [Number Notes <br />70 <br />MENEM <br />�m <br />o <br />Relinquish <br />' <br />Date: <br />Time: <br />Laboratory: I <br />Courier: <br />Received b : <br />Date: <br />Time: <br />Relinq•uished by: <br />Date: <br />Time: <br />Received by: <br />Date: <br />Time: <br />Relinquished by: <br />Date: <br />Time: <br />Received by: <br />Date: <br />Time: <br />�r <br />Requested Tum Around Time (circle . 24 hours 4 hours 72 hours 5 days (standard) Other:_ _ <br />Matrix Codes: A = Air W = Water S = Solid <br />Special Instructions to lab: <br />1 hereby authorize the performance of the above indicated work. <br />Global ID: <br />'otracker EDF to: 0 geotracker@advgeoenv.com ❑ <br />
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