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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0545308
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Last modified
2/10/2020 7:33:31 PM
Creation date
2/10/2020 4:58:48 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0545308
PE
2959
FACILITY_ID
FA0000932
FACILITY_NAME
DOMINO'S #8588
STREET_NUMBER
305
Direction
S
STREET_NAME
HUTCHINS
STREET_TYPE
ST
City
LODI
Zip
95240
APN
03319020
CURRENT_STATUS
02
SITE_LOCATION
305 S HUTCHINS ST
P_LOCATION
02
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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SEQUOIA ANALYTICAL U680 Chesapeake Drive • Redwood City, CA 94063 • (650) 364-9600 FAX (650) 364-9233 <br /> 11819 Striker Ave., Suite 8 • Sacramento, CA 95834 • (916) 921-9600 FAX (916) 921-0100 <br /> NI CHAIN OF CUSTODY ❑ 404 N.Wlgel Lane • Walnut Creek, CA 94598 • (510) 988-9600 FAX (510) 988-9673 <br /> Company Name: Equilon Enterprises LLC Project Name: ZJ ef( - 2 — L"� <br /> Address:Texaco Loc.# q2Q (atgt) 3W 5 Billing Address (if different): 108 Cutting Boulevard <br /> City: L CDT> 1 State: CA Zip Code: <br /> Richmond, California 94804 <br /> Telephone: (510)236-3541 FAX II: (510)237-7821 P.O. It: <br /> Report To: Sampler: jt OC Data: ❑ Level D (Standard) U Level C ❑ Level B ❑ Level A <br /> Turnaround U10 Working Days -❑3 Working Days ❑2 - 8 Hours ❑ Drinking Water Analyses Requested <br /> Time: ❑ 7 Working Days ❑2 Working Days NeWaste Water 'b <br /> ❑ 5 Working Days ❑24 Hours 3� ❑Other -{ 1 bti� aye ��U <br /> Client Date/Time Matrix It of " 'Cont. Sequoia's <br /> 4 y� � ti��� ��� ay5 <br /> Sample I.D. Sampled Desc. Cont. Type Sampla it 3Q�� yG� $�w Comments <br /> 1. /MW-1 *Z ' <br /> _2. M W'2- 6 N t <br /> Jc- <br /> 3. r4 w <br /> 4. 1 "1 '1� 0 � 13y., t" <br /> 5. �f�i.�+,3;ii' ��'G`atSi.'{ a:,Slliti�l 5Nu1�•3t Vfi ' � 4 A��" ' 6�/ 1 41 <br /> A ySl Hyl. , �,j1 CSr -d� S <br /> 6. <br /> i i t 1 <br /> 7. d rl �.r "H. i <br /> !. IM, <br /> M' it y � y <br /> _ t e .'•,^PYA i .7tili``7 :!�� tgJ: 9�.iCi� �� �. iiSF ;!;li'I <br /> 8. <br /> 9. <br /> 10. <br /> Relinquished By: ,, DaTime: j Z Received 1. <br /> D Time:(Z. <br /> Relinquished By: Date: Time: Received By: dna ISL Dale:%240Time: 0.oS <br /> Relinquished By: Date: Time: Received By Lab: Date: Time: <br /> Were Samples Received In Good Condition? ❑Yes ❑ No Samples on lee? ❑Yes ❑ No Method of Shipment Panr of <br /> a <br />
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