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ARCHIVED REPORTS_XR0003824
Environmental Health - Public
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EHD Program Facility Records by Street Name
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L
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LOOMIS
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2969
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3500 - Local Oversight Program
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PR0545428
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ARCHIVED REPORTS_XR0003824
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Entry Properties
Last modified
3/9/2020 1:14:17 PM
Creation date
3/9/2020 10:41:43 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0003824
RECORD_ID
PR0545428
PE
3528
FACILITY_ID
FA0005487
FACILITY_NAME
MARCIS DIESEL SERVICE
STREET_NUMBER
2969
STREET_NAME
LOOMIS
STREET_TYPE
RD
City
STOCKTON
Zip
95205
CURRENT_STATUS
02
SITE_LOCATION
2969 LOOMIS RD
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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mo--1 <br /> -- ANALYTICAL REQUEST/S AIVIPCHAIN OF CUSTODY-- LAB TRACKING # ------------------------- <br /> RECORD OIC' _ DATE RECIEVED <br /> DEL TECH :GEOTECHNICAL SUPPORT SERVICES LAB INVOICE TO --------------- —- .....-.------ -------10624 OLIVE AVENUE,CA 95361OFFICE-(xo9)$47-V -FAX -(209)841.7744 PH# ( -)- CONTACT -----�-_.-..------------------------------------------ <br /> CALIFORNIA CONTRICENSE#6573661 CLASS"A"ENGINEERING LAB Ar1nLYSIs TkD SITE SAMPLING MAP <br /> CLIENTS CONSULTANT <br /> SITE NADkE L PROiEC T <br /> ADDRESS � ` (. `t',�S CTTv ST ' " o a <br /> 0 <br /> SAMPLER SIGNATURE 0 <br /> SIIIPPED VIA WAYBILL# "�"• C? p m ►� a <br /> � <br /> 1ANALYSISBY TURNAROUND TIME -^ 1 iz�g�T'1a%DA4zW D DAYS �: w ago <br /> I` SAMPLE I D R DATE TIME CONTAINERS TYPE MATRIX �' I, "` ' REMARKS I LAB I D <br /> I) b r% ' <br /> 2) r' - 4 I <br /> 3) 4 0 <br /> 4) `t4 C <br /> 6) d _ <br /> Io) 1 14 � <br /> L2) uj <br /> 13) <br /> 14) <br /> t5) <br /> DA ! DATa l E <br /> RmJ(() TsH(DRI j ' REC.[VFDBr r� j' t7� ,Vf� // f`� ``1 SAMPLEINTEGRITYICONDITION <br /> (SIGNATURE) � � 4� /7 [7 " RECEIVED COLD&INTACT! ) NO f ) <br /> yI A f 'DAT1:17ALE <br /> RELINQUIVIED BI 1 , (/// r (u S RB(EIvED BI y� —A0—� AIR BUBBLES IN V O A S /YPS NO LIN N <br /> ,' (SIONATLTRE) r/� 7 _f fi' ( #`� CUSTODY SEALS INTACT I YES V^r NO ( N/A f l <br /> 1/ v A ITTM DATE ITIME <br /> AF].uvQUIs4IInat I Rt1VEDBt PRESERVATIVESUSED 1 'IES NO <br /> ! (SIGNATURE) I O V <br /> NOTE PLEASE ARCHIVE THU SAMPLES SUBMITTED FORTHE FULL HOLDING TIME ALLOWED UNLESS OTHER ARRANGEMENTS ARE MADE * (MTBE TAME E T.B.E,D I.P.E,T.B.A) <br /> B B =BAILER BLANKS COLLECTED IN THE FIELD F B -FIELD BLANKS COLLE=IN TW FIELD <br /> PINK FIELD COPT WHITE&i ELLOIN TO LAB W ITH S4MPLES 1 ELLOW RETURN TO CLIENT WITH RFSULTS DEL-TECH C 0 C FORM 98 <br />
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