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ARCHIVED REPORTS_XR0007136
Environmental Health - Public
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EHD Program Facility Records by Street Name
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E
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88 (STATE ROUTE 88)
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14000
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3500 - Local Oversight Program
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PR0544811
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ARCHIVED REPORTS_XR0007136
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Entry Properties
Last modified
11/20/2024 9:21:18 AM
Creation date
9/5/2019 1:43:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007136
RECORD_ID
PR0544811
PE
3528
FACILITY_ID
FA0000091
FACILITY_NAME
Colonial Energy CE 40138 (DBA Power Mart)
STREET_NUMBER
14000
Direction
E
STREET_NAME
STATE ROUTE 88
City
LOCKEFORD
Zip
95237
CURRENT_STATUS
02
SITE_LOCATION
14000 E HWY 88
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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i <br /> Chain of Custody Number <br /> SECORII Chain-of Custody Record <br /> Feld Office 077 Sacramento !! I[ <br /> Additional documents are attached, i and ai a part of t <br /> Address 3017 Kilgore Road Suite 100 �� Job Name Time Oil <br /> Rancho Cordova CA 95670 Location 14000 East Highwav 8811 <br /> ` II _Lockford,CA 11 <br /> Project# 770TA1737.00 Task# 0005 [I Analysis Request <br /> Project Manager Todd Brown a <br /> Laboratory ExelChem ' a w j <br /> Turnaround Time Standard a w m " I tD a <br /> s � o L <br /> au � " � D a <br /> Sampler's Name Brad Blanks hi 0 8 o a m ,S r p M « _ U <br /> Sampler's Signature E A E m W m y y o rf, q w m a <br /> �Sample ID <br /> DateComments/ <br /> a CW" cwo" <br /> InSin]CtlonS z <br /> QCEB �W�9�� d� Water X �[ X Lo 6 <br /> QCTB Water X I[ ' <br /> I[ Z 3 <br /> E !I <br /> ' II <br /> E I[ I <br /> II II <br /> I[ I[ <br /> + II I[ <br /> II II <br /> II II <br /> Special instructions(Comments Relinquished by Received by Sample Receipt <br /> EDF Required: Please Email Stacle Hartung at Sign I� Sign <br /> shartung@seoor.com - Aa2Z� Total no of containers <br /> 9 Print Brad Blankenshl Print Gain of custody seals <br /> Fax Results to: Company TiII SECOR Company 6 ,.-, Recd in good conddioNcold <br /> 1)Todd Brown fax 916-861-0450 me I DatTime �54 Date 16_ r Conforms to record <br /> � z <br /> Relinquished by _ Received by <br /> Sign Sign Client Secor <br /> Print II Print Client Contact Todd Brown <br /> Company ! Company Client Pune 91"61-M <br /> scat Time II DateTime Date ext.233 <br /> asraFo a�aae � � <br /> I -%�I[ Page Date G� g of 2 <br /> u <br />
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