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Environmental Health - Public
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EHD Program Facility Records by Street Name
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GRANT LINE
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575
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2900 - Site Mitigation Program
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PR0542420
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Entry Properties
Last modified
1/23/2020 9:30:57 AM
Creation date
1/23/2020 9:25:37 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
WORK PLANS
RECORD_ID
PR0542420
PE
2960
FACILITY_ID
FA0024376
FACILITY_NAME
FORMER CHEVRON 98632
STREET_NUMBER
575
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
575 W GRANT LINE RD
P_LOCATION
03
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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Ll <br /> L <br /> Fan copy of Lab Report and COC to Chevron Contact : El Nos Chain - of - Cusfod — Record <br /> Z :Zzr <br /> Chevron Focillty Number _ Chevron Contact (Name) <br /> Facilely Address_ (Phone) l <br /> Chevron U.S.A. Inc. f20� 6r <br /> P . O . BOX 5004 Consultant Project Number laboratory Name <br /> San Ramon, CA 94583 Consultant No Laboratory Release Number , <br /> FAX (415)842 -9591 Address ! �/ Samples Collected <br /> Project Contact (Name-))�j (/ -� Collection Data _ <br /> (Phon Q % 5 5 ✓` a (Fax Number). SI <br /> Anclyss T Performed <br /> o Q <br /> All <br /> 0E I0915 <br /> E <br /> x LogrR3 uuo L + o 'o°'O''' 'cr'i � ' iii Yg �io 'a <br /> E a E 11 g E E o xm O1a � �m em m O <br /> _ � LS o" �" `� � c Remarks <br /> Jf <br /> 4 <br /> A, AAA <br /> G <br /> FL <br /> 4— <br /> PI ase i ilial : <br /> L Sa ple Stor d in i e <br /> I Appropi i ate cDntoii iers <br /> _ <br /> VC A's vitho =h osaac <br /> Co me ts: <br /> AAA <br /> ! ff <br /> Tei: TI I <br /> m R•Ilnquls ed octan) Organization Dats%nms/s; , 45R eMed By (Signature) Organization Date/Time Tum Around Time (Circle Choice) <br /> lee le, <br /> — <br /> 24 Nn. <br /> e sll � (Signature) 0 anlzation DoG/Time Received By (Signaturs) Organization Date/'"me 4e Hoes. <br /> 5 Days <br /> " 10 Days _y <br /> Rsllnq✓I hod By (Signature) nlzctlon Dots/ nrne 1p re By (Signature) Date/Time1 Contracted--- <br />
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