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ARCHIVED REPORTS_XR0012182
Environmental Health - Public
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3500 - Local Oversight Program
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PR0545229
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ARCHIVED REPORTS_XR0012182
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Entry Properties
Last modified
1/24/2020 12:53:01 PM
Creation date
1/24/2020 11:54:26 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012182
RECORD_ID
PR0545229
PE
3526
FACILITY_ID
FA0003903
FACILITY_NAME
TOSCO CORPORATION #31258
STREET_NUMBER
4707
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
10816004
CURRENT_STATUS
02
SITE_LOCATION
4707 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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000465 <br /> ❑ 885 Jarvis Drive • n Hill, CA 95037 • (408) 776-9600 • FAX (408) 782-6308 <br /> 0 .0O O L C J Q 819 Striker Ave , S • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-010 <br /> 0 <br /> ❑ 404 N Wiget Lane •Walnut Creek, CA 94598 • (925) 988-9600 FAX (925) 988-9673 <br /> TOSCO3Z��-� ❑ 1455 McDowell Blvd North, Suite D • Petaluma, CA 94954 • (707) 792-1865 FAX (707) 792-0342 <br /> 1551 industrial Road • San Carlos, CA 94070 • (650) 232-9600 FAX (650) 232-9612 <br /> Consultant Company (771-Ir A— zi Project Name > t-{ p t 4t , D 1- <br /> Address <br /> Address 6 77 ti 7 S TOSCO Engineer (required) <br /> City State Zip Code r7 <br /> Telephone �5 _ c� �, -7 7 FAX # "O-S - S -- 7*-SC Site #, City, State } �rtx C A T) <br /> _m <br /> -It <br /> Re ort To k Sampler - OC Data KLevel D (Standard) LiLevel C D Level B ❑ Level A v <br /> Turnaround } 10 Work Days ❑5 Work Days ❑3 Work Days ❑ Drinking Water Analyses Requested a I ' <br /> Time 2 Work Days L-J 1 Work Day ❑2-8 Hours Cl Waste Water <br /> CGDE' ©Misc O Detect ❑ Eval O Remed ❑ Demol ❑ Closure l7 Other boa o, o, 4& <br /> Client Date/Time Matrix # of Cont Sequoia's `eP `P `p �`P �� c� Comments <br /> Sample i D Sampled Desc Cont Type Sample # <br /> 1 57— r - <br /> 0 <br /> 2 r3 -U� t <br /> 3 W Cr <br /> �� tc <br /> ' <br /> 3 <br /> 4 0 <br /> 5 <br /> 6 <br /> 7 <br /> 8 <br /> 9 ca <br /> 0 <br /> 10 J Cr <br /> Relinquished By Date-3-,22-otq Time Received By ;, Date��Z �C Time <br /> Relinquished By Date Time Received By Date Time <br /> Relinquished By Date Time Received By Date Time <br /> Were Samples Received in Good Conditions es ❑ No Samples on Ice? ❑Yes O�o Method of Shipment Page 1 of <br /> To be completed upon receipt of report <br /> 1) Were the analyses requested on the Chain of Custody reported? ❑Yes © No If no, what analyses are still needed? <br /> 2)Was the report Issued within the requested turnaround time? ❑Yes i3 No If no, what was the turnaround time? <br /> Approved by Signature Company Date I <br />
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