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ARCHIVED REPORTS XR0006299
Environmental Health - Public
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EHD Program Facility Records by Street Name
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Y
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YOSEMITE
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1048
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3500 - Local Oversight Program
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PR0544939
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ARCHIVED REPORTS XR0006299
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Entry Properties
Last modified
10/18/2019 9:15:53 AM
Creation date
10/18/2019 9:11:07 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006299
RECORD_ID
PR0544939
PE
3528
FACILITY_ID
FA0000508
FACILITY_NAME
7-ELEVEN INC #17647
STREET_NUMBER
1048
Direction
W
STREET_NAME
YOSEMITE
STREET_TYPE
AVE
City
MANTECA
Zip
95337
APN
21903003
CURRENT_STATUS
02
SITE_LOCATION
1048 W YOSEMITE AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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I <br /> Chain of Custody Number <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 7-Eleven Store#17647 <br /> Rancho Cordova,CA Location 1048 West Yosemite Ave <br /> Manteca, California <br /> Project# 77EL.17647 03 Task# 0410 Analysis Request <br /> Project Manager gaff Auchterlonie <br /> o <br /> Laboratory Kiff Analytical W � N U <br /> Turnaround Time Standard <br /> rL c s <br /> ELICL <br /> Sampler's Name Torn Miller X � W � 0 � <br /> Sampler's Signature a �, N m a m Q g > CM O0(Sol Comments) <br /> a _ <br /> Sample iD Date Time Matrix = a e 8 Nw = n ww ° w Instructions z' <br /> MW-11 zo oa /570 Water X X <br /> MW-2 Water X X <br /> MW-3 3/a ,3 45 Water X X <br /> Special Instructions/Comments Relinquished by Received by Sample Receipt <br /> 7 Oxygenates TAME, MtBE, EtBE,TBA, DIPE, EDB & Sign Sign Total no of containers <br /> 1,2 DCA Print ��., �iiPrint Chain of custody seals <br /> Global ID#T0607700351 (SIRC) Company Company Rec'd in good condition/cold <br /> EDF Deliverables Time Date Ti D to Conforms to record <br /> email results to bcarey@secor com Relinquished by Rece d b <br /> Sign Sign Client SECOR <br /> Print Print �►,{J Client Contact Brian Carey <br /> Com Company Fir Client Phone (916)B61-MO <br /> e Date Time ext.241 <br /> $ECOR CUSTREC Rev 2MO <br /> Date Page <br />
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