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ARCHIVED REPORTS_XR0007181
Environmental Health - Public
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EHD Program Facility Records by Street Name
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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_XR0007181
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Entry Properties
Last modified
11/20/2024 9:21:19 AM
Creation date
9/5/2019 1:49:52 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007181
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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AIM& <br /> Cham of Custody Number <br /> r <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento E3 Additional documents are attached, and are part of this Record <br /> Address 3017 Kilgore Road,Suite 100 Job Name Time Oil <br /> Rancho Cordova,CA 95670 Location 14000 East Highway 88 _ <br /> Lockford,CA <br /> Project # 770T 41737 00 Task# 0003 Analysis Request <br /> Project Manager Todd Brown <br /> Laboratory ExelChem a a a <br /> Turnaround Time Standard m }a. LU, b �, <br /> C . m <br /> Sampler's Name Brandon Schlegel c S 0 0 W cm a o a aU. <br /> m o ro °l a p T <br /> Sampler's Signature II, E Ld m m N m o ; R a o <br /> zT x � °.° m a ?� 9g;° Ea � No Commentsr E <br /> Sample ID Date Time Matrix o co m 2 w � m : m r ; u, m a w t, a 2 Instructions z' <br /> QCEB `l t o lq (, Water X X N0404152 6 <br /> QCTB Water X X 151.4 3 <br /> Special Instructions/Comments Relinquished by Receive b <br /> Sample Receipt <br /> EDF Required Please Email Stacie Hartung at Sign Sign Total no of containers <br /> shartung@secor com Print Brandon Schlegel Print Chain of custody seals <br /> Company SECOR Company Rec'd in good conditionicold <br /> Fax Results to Time Date '1# i Utt Time DatE Conforms to record <br /> 1)Todd Brown fax 916-861-0430 Relinquish by Received by <br /> Sign Sign Client Secor <br /> Print Print (,y/z— (!-- Client Contact Todd Brown <br /> Company Company e c c.(", � Client Phone 916-861-0400 <br /> Time Date Time Dat s ext 233 <br /> CECOR CiiSTREC Rer ar99 <br /> Date .__ Page 2 of 2 <br />
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