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ARCHIVED REPORTS_XR0002169
Environmental Health - Public
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EHD Program Facility Records by Street Name
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G
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GRANT LINE
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2360
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3500 - Local Oversight Program
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PR0545207
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ARCHIVED REPORTS_XR0002169
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Entry Properties
Last modified
1/27/2020 4:22:32 PM
Creation date
1/27/2020 3:46:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002169
RECORD_ID
PR0545207
PE
3528
FACILITY_ID
FA0007735
FACILITY_NAME
7-ELEVEN INC #32262
STREET_NUMBER
2360
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
APN
23819001
CURRENT_STATUS
02
SITE_LOCATION
2360 W GRANT LINE RD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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Chain of Custody Number <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento E] Additional documents are attached, and are part of this Record <br /> Address 3017 Kilgore Road,Suite 100 Job Name 7-Eleven Store 932262 <br /> Rancho Cordova,CA Location 2360 West Grant Line Road <br /> Tracy,CA <br /> Project# 77EL.32262.04 Task# 0410 Analysis Request <br /> Protect Manager Jaff Auchterionie <br /> Laboratory Ktff Analytical CO w <br /> Tumaround Time Standardst' X A N <br /> o Z g0 � � <br /> Sampler's Name Tom Miller W g ` N V N c6 <br /> m y l6 +m„ .6 <br /> Samplers Srgnaturg _ Eo S E m $ Comments! <br /> a. a a <br /> Sample ID Date W 40a InstruconsTiz' <br /> fAW.1 -6 Qrlb W44., x X X B( 3 <br /> ol <br /> MW-2 b - 0-6V w x X X DZ, 3 <br /> Ir- <br /> MWS 1,2-1/1'7-SC)..a w x X X p 3 <br /> WIW-4 /32-S - -0q oft x I X X 3 <br /> MWS L oy A <br /> ffX X X 3 <br /> MW40 20 -0 x X X s 3 <br /> MW 7 �-3c?—use I x X X 07 3 <br /> MW4 7%3D-a X X X D 3 <br /> J MW-9 7 .a 400 k, X X X 3 <br /> TP4 -,5p•o X X to 3 <br /> Special Instructwns/Comments Relinquished b Received by Sample Receipt <br /> 5 Oxygenates:TAME,MtBE,EtBE,TBA,DIPE Sig Sign Total no of oontainers <br /> Global ID#T0607729S62(SIRC) Print Print Chain of custody seals <br /> email EDD to dacatlin@secor.com Company .�' � s Compan Recd in good condition/cold <br /> email lab results to dherzog@secor corn and Time Date ? Date Conforms to recons <br /> bcarey@secor.com Relinquished by- Received <br /> Sign Sign Client SECOR <br /> Pint Print /G Client Contact Brian Carey_ <br /> Compa Company Z 1 r v Y Client Phone (916)861_-WO <br /> Date Time Lf DateO d oL ext.241 <br /> SECMWSW=RW 2M <br /> Date ,7 Page <br />
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