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ARCHIVED REPORTS_XR0012125
Environmental Health - Public
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3500 - Local Oversight Program
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PR0541875
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ARCHIVED REPORTS_XR0012125
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Entry Properties
Last modified
3/16/2020 11:17:33 PM
Creation date
3/16/2020 2:47:18 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012125
RECORD_ID
PR0541875
PE
2960
FACILITY_ID
FA0024017
FACILITY_NAME
CHEVRON SITE 306415
STREET_NUMBER
437
Direction
E
STREET_NAME
MINER
STREET_TYPE
AVE
City
STOCKTON
Zip
95202
APN
1392417
CURRENT_STATUS
01
SITE_LOCATION
437 E MINER AVE
P_LOCATION
01
QC Status
Approved
Scanner
SJGOV\sballwahn
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EHD - Public
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O 885 Jarvis Owe•Morgan 1-11%CA 95407-(408)776.9600■FAX ON)782-M ❑18939120th Ave.,N.E_Sui[e 101 •bothe7l,WA 96011•(208)481.9200 <br /> UNOCALO 819 Striker Ave.,Sulle 8-Sncramen%.CA 95834•(916)921-9600 U Ea91 i 4115 Montgomery.Side 0 4 Spokane.WA 99206-(509)W-0200 <br /> O 404 N.Nfrgel lane•Walnut Creek.CA 94598•(925)988.9600 a 15055 S.W.ssquoin Pkwy,Suite 110•Portland,OR 97222-(500)624-9800 <br /> O 1455 McDowell Btvd.Horth.Suite D+Pelaluma.CA 94954+(707)792-1865 GLOBAL 10 70607700539 <br /> Consultant Company: Ge t t,ler-R an Inc. <br /> ProJcct Name: Former CFnocgl X0187 <br /> Address: 6747 Sierra Court, Suite 3 UNOCALProject Manager(required): Hick Nickerson 9I6-714-3205 <br /> y; State: zip Code: 94568 AFE #; <br /> Cit Stt <br /> Dublin CA _._..... ---- <br /> Telephone: 25-'551-7553 _ FAX#: - 925-551-7899 Site 9,City,State: ¢0187, 437 FaKe miner Avenue, Seockron, CA _ <br /> 9 --- t' <br /> Resort To: Deanna 1„ Hardin Sampler: rn�, <br /> I`► a DC Data: to V01 D(Stanaald) ❑Level C 0 Level e ❑Level A <br /> Analyses Requested G <br /> Tumaround ❑ 10 Work Days U 5 Work Days 3 Wank Days U Drinking Water °1- <br /> Time: ❑ 2 Work Days ❑ 1Work Day :12-8 Hours ❑Waste WaterAL <br /> y-D <br /> ti . 4 <br /> CODE: J Mise. a Detect. ❑Eva1. ❑Remed. O Demol. 0.Closure a other � , C � <br /> Client Date/Time Matrix #of Cont. Laboratory �t, t'"� Comments <br /> Sample I.D. Sampled Desc. Cont. Type, Sample# <br /> GA L. ---- 5 O.W5 by�82110 O � <br /> V 1G — •-t ntiritL,TRA. <br /> DIP P,J'FAE, _J <br /> TANIE <br /> 3. <br /> --O <br /> 4. V- 30163 offi .� <br /> 5, -t , l30 a3 oda `05 <br /> 6. <br /> loss ~D <br /> 7. UGC 3 a 1�� <br /> S4103 A/O <br /> dxD <br /> . <br /> 10 U! <br /> 10. <br /> ter Date: Time: of <br /> Relingcrished By: Date: Time: J frv6_ Recelved By; <br /> � t <br /> Relinquished BY <br /> Date: °�' Time: = Received By: Dafe:L 0 - Time: <br /> __.._. < <br /> Relingttished 6y: Dat�E+ Tirno:13 4O Recetved By. Sl ease - Time: <br /> Were Samples Recetv nd aCo clition? ❑Y Samples on ice? O Yes ONO Meth at ShTP dnt Page of a <br /> To be completed upon receipt of report: a' <br /> i)Were the analyses requested an the Chairs of Custody reported? Q Yes ❑No If no,what analyses are Still needed? _. <br /> F)Was the report issued within the requested turnaround time? 0 Yes Q No If no,what was the turnaround time? <br /> Approved �!'l / 4- 115!!;o,1_ Signatur . Company:a-,4e-�C o ��� <br />
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