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COMPLIANCE INFO_2020
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2300 - Underground Storage Tank Program
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PR0518458
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COMPLIANCE INFO_2020
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Entry Properties
Last modified
10/14/2021 1:42:41 PM
Creation date
1/17/2020 12:05:35 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2300 - Underground Storage Tank Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0518458
PE
2361
FACILITY_ID
FA0013918
FACILITY_NAME
CHEVRON STATION #210997*
STREET_NUMBER
1442
STREET_NAME
COLONY
STREET_TYPE
Dr
City
RIPON
Zip
95366
APN
26102028
CURRENT_STATUS
01
SITE_LOCATION
1442 Colony Dr
P_LOCATION
05
P_DISTRICT
005
QC Status
Approved
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SJGOV\kblackwell
Tags
EHD - Public
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00 NEENNONNOW U011 <br /> MCCAMPSELL ANALYTICAL, INC. CHAIN OF CUSTODY RECORD <br /> 1534 Willow Pass Read TURN AROUND TIME [a91 <br /> Pittsburg, CA 94565-1701 <br /> Website: www.mccomobell.com Email: main@mccampbell.com RUSH 24 HR 48 HR 72 HR 5 DAY <br /> Tele hone: 92 2524262 Toll Free 87 2524262 Fax: 92 252-2969 EDF Required [circle one] ? ICoelt Normal Write On (DW) No EDF required <br /> Report To: IVB Z r'QA Bill To: 6 L4V nal sis RequestI Other lComments <br /> Company: GHD <br /> 11/ Reserve hr a Filter <br /> oSav� ll� Cgi b E-Mail: rmeA4wme , ibrelh:otL ,to Samples <br /> Tele: — S - s Sof Fax: .wn & for Metals <br /> 10 analysis: <br /> Project #: 112. 0 gJf i 2- Project Name: R; oh xei4centepir G V1G Yes / No <br /> Project Location , / N'r!' 2• i/V Cc•/oh &• 4n ca gS31� 4 r�o <br /> Sampler Signature* <br /> SAMPLING MATRIX THOD mop X <br /> NOW PRESERVED Z <br /> SAMPLE ID LOCATION 4. v <br /> (Field Point Name) :+ <br /> Date Time cOC <br /> Doss MC <br /> a. <br /> Fes' ca *am <br /> C mass WE z <br /> Q W <br /> ~ �-- <br /> L2- C t#lzx, 13ts <br /> 3 � 4 & it. t v ] 3 <br /> S "4 eif5 1/2y 3 ?� <br /> 1 1 x i <br /> 11 35s <br /> t <br /> elfin fished Date: Ti Re' y: ICEIC COMMENTS: <br /> GOOD CONDITION Email results to: <br /> HEAD SPACE ABSENT <br /> Time:Relinquished By: NEEM Date: e: Rece ved B DECHLORINATED IN LAB <br /> APPROPRIATE CONTAINERS <br /> PRESERVED IN LAB <br /> Relinquished By: Date: Time: Received By: pRESRVATIONVOAS ( O&G I METALS ( OTHER <br /> *PIease circle water type: <br /> GROUND WASTE DRINKING RECREATIONAL EFFLUENT <br /> Page 35 of 36 <br />
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