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ARCHIVED REPORTS_XR0002183
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_XR0002183
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Entry Properties
Last modified
1/27/2020 4:06:05 PM
Creation date
1/27/2020 3:50:03 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0002183
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
Tags
EHD - Public
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An a <br /> CImwhain of Custody Number0 1 Chain-of Custody Record <br /> Field Office 077 Sacramento El Additional documents are attached, and are part of this Record <br /> Address 3017 Kilgore Road, Suite 100 Job Name 7-Eleven Store 432262 <br /> Rancho Cordova, CA Location 2360 West Grant Line Road <br /> i <br /> Tracy, CA <br /> Project# 77EL 32262.03 Task# 0410 Analysis Request <br /> Protect Manager Jaff Auchterlonie y <br /> Laboratory Kiff Analytical t a <br /> Turnaround Time Standard <br /> 0 a <br /> C� o <br /> 'Sam lens Name Tom Miller _a0 <br /> N O <br /> Sampler's Signatur Qt F' a II T ' N c O r <br /> ao n o �'a <br /> a �W v 0o mN � o >, N mm <br /> U a. a. a oa � a °!e E ° mw Comments/ <br /> Sample ID Date Time Matrix X � w W Q 0 � ( z � 0 w <br /> Instructions z <br /> -r MW-1 x X X 3 <br /> MW-2 /�'Yay ///r x X X <br /> ,e MWS 3 <br /> c� x X X <br /> MW-4 /-iso y 330 x X 3 <br /> X 3 <br /> MW-5 630 r-, x X X 3 <br /> MW-6D -/yam /}oo e/,)b4T x X X 3 <br /> Special Instructions/Comments Relinquished by �.�dReceived by Sample Receipt <br /> 5 Oxygenates* TAME, WBE, EtBE, TBA, DIPE Sign Sign Total no of containers <br /> Global ID#T0607729562 (SIRC) Print ��l Print Chain of custody seals <br /> EDF Deliverables(email EDF to dacatlin@secor com) Company �S7 Company Recd in good condition/cold <br /> email lab results to dherzog@secor com Time Date Time Date Conforms to record <br /> Relinquished by Received b _ <br /> Sign Sign c/ Client SECOR <br /> Print Print Client Contact Brian Care <br /> Company Company _�� FClient Phone X916)861-0400 <br /> Time Date Time /,�z S- �DatcoJ JS 4` ext 241 <br /> sEcoa aJsTWc Ray 2M <br /> Date /_/y_d Page <br />
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