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ARCHIVED REPORTS_XR0011317
Environmental Health - Public
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EHD Program Facility Records by Street Name
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F
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FREMONT
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1401
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3500 - Local Oversight Program
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PR0545145
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ARCHIVED REPORTS_XR0011317
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Entry Properties
Last modified
1/9/2020 11:32:50 AM
Creation date
1/9/2020 11:14:26 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011317
RECORD_ID
PR0545145
PE
3528
FACILITY_ID
FA0003820
FACILITY_NAME
VALLEY WHOLESALE DRUG
STREET_NUMBER
1401
Direction
W
STREET_NAME
FREMONT
STREET_TYPE
ST
City
STOCKTON
Zip
95203
APN
13525031
CURRENT_STATUS
02
SITE_LOCATION
1401 W FREMONT ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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SJGOV\wng
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EHD - Public
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t <br /> -- ANALYTICAL REQUEST/SAMN CHAIN OF CUSTODY -- LAB.TRACKING U: z <br /> RECORD OF (6) .�� DATE RELIEVED: <br /> LAB.INVOICETO: —�l � 1��.2� — -- ----- ---- <br /> DEL-TECH GEOTECHNICAL SUPPORT SERVICES / <br /> At <br /> -- <br /> 10624 OLIVE AVENUE,OAKDALF,CA.95361 —1 s_Q .----------_)------------ `�_v--------- ------------ )--�'!:-�-4-•- -- <br /> OFFICE-(209)847.8757 <br /> FAX -(209)847-7744 PH.# � }��! CONTACT• <br /> CALIFORNIA CONTRACTORS LICENSE#657366!CLASS••A••ENGINEERING OB# � �_�___INVOICE#---.----- ------P.O.# <br /> IIII II ill'I�I €€ VIII II €131 fIE rl�'jll[I I I €i li!i'filll III I fl f lyrl I II 11'11€III''i i l lr lil'I llillll ! €gill €i i II IUii III EI i I;L€1 111 I II€n 'il !' LAB.ANALYSIS REQUESTED <br /> I i I I I' ' III SITE SAMPLING MAP <br /> !€ IIII,�;I!rlalll r;�tlq€r!,r.tl .r.11rlu II d':i € � hl.rrin 1 .�III a II I Ir it i 11.11111 .I,11....J II,I t ill .in �--�€...IulJarrll�ll II€hl.h ISI I d I ilr I alr.E <br /> CL�NT: V�vV I D 1 CONSC)LTANT: <br /> SIPS NAME: L Yv I 1 . 1"^� <br /> ADDRESS: I CITY: O <br /> o c E4 <br /> SAMPLER SIGNATURE 11r}� 3 o o o <br /> SIPPED VIA WAYBILL#• <br /> ANALYSIS BY: <br /> TURNAROUND TII41E: DAY W ew So W wW <br /> 3 <br /> I SAMPIBI U s D.iTE TIME CONTAINERS "PE MATIux !I! VIII !II III I III III II! !!, I I! i !! II' !!I i REMARKS/LAB.I.D. <br /> 2) �p 2 <br /> C <br /> 4) ♦u k� <br /> S.) <br /> 7) <br /> 9.) <br /> 10) <br /> 11.) <br /> 12.) <br /> 13.) <br /> 14.) <br /> IS) <br /> REUNOULSHMS-1-. ; <br /> 1 RI�JVEDPy. 1 �� / � SAMPLE INTEGRITY CONDITION <br /> n f <br /> ~ r (SscmAT�mel �J 221 RECEIVED COLD A INTACT I YFS No ( 1 <br /> n <br /> RFLINQUL%M BY. RECMTD 6Y: r y1 AIR BUBBLES IN V.O.A.S I YES NO LIN S)N- <br /> "r"`— fSialuTUnE) C/ CUSTODY SEALS INTACT I YEs ) NO ( N!A ( 1 <br /> OF DAMITIME DATE/ E <br /> BY: PRESERVATIVES USED I YES NO <br /> I (SXMTURE) u <br /> NOTE: PLEASE ARCHIVE THESAMPLFSSUBMITTEDFORTHEFULLHOLDINGTIMEALLOWED.UNLESSOTHERARRANGEMENTSAREMADE•. � (M.T.B.E.,TA.M.E.,H.T.B.E.,D.I.P.E.,T.B.A.) <br /> B.B.=BAILrR BLANKS COLIJiCCED IN THE FIELD. F.B.=17ELD BLANKS COLLIX-I'll)IN 1'1-9 MELD. <br /> PINK•FIELD('OP1' WHITE&1'ELL(1K'-TO LAB.WITH SAMPLES YELLOW-RETURN TO CLIENT WITH RESULTS Dra,TFCH C.O.C.FORM 98 <br />
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