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ARCHIVED REPORTS_XR0004951
Environmental Health - Public
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EHD Program Facility Records by Street Name
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M
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MOSSDALE
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444
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3500 - Local Oversight Program
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PR0545585
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ARCHIVED REPORTS_XR0004951
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Entry Properties
Last modified
9/15/2020 11:37:43 PM
Creation date
3/19/2020 3:20:01 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0004951
RECORD_ID
PR0545585
PE
3528
FACILITY_ID
FA0000212
FACILITY_NAME
Mossdale Chevron
STREET_NUMBER
444
Direction
W
STREET_NAME
MOSSDALE
STREET_TYPE
RD
City
LATHROP
Zip
95330
CURRENT_STATUS
02
SITE_LOCATION
444 W MOSSDALE RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\sballwahn
Tags
EHD - Public
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McCamp ell Analytical Inc. CHA�N-OF�CUSTODY RECORD page 1 of 1 <br /> 110 Second Avenue South,#I37 <br /> Pacheco,CA 94553-5560 <br /> (925)798-1620 WorkOrder 0206465 <br /> Client <br /> Advanced Geo Environmental, Inc TEL (209)467-1006 <br /> 837 Shaw Road FAX (209)467-1918 <br /> Stockton, CA 95215 ProjectNo MPB-Mossdale <br /> PO 28-.Tun-02 <br /> -- Requested Tests <br /> Sample ID ChentSamplD Matrix Collection Date Bottle [ S�"021B/80115 SW8260B <br /> 0206465 001 MW-1 052702 --- Water 6127/02 12 32 00 PM f--- B -r-- A C --- — ` --- ---' -- - --- <br /> 0206465-002 MW2 062702 Water 6127102 10 49 00 AM B A C <br /> 0206465-003 MW3 062702 Water 6127102 12 04 00 PM B A C �— <br /> 0206465-004 MW4 062702 Water 6127/02 10 07 00 AM B A C <br /> 0206465-005 MW5 062702 Water 6127/02 1132 00 AM B A C _ <br /> Comments. <br /> - -- ------ DatelTtme -- — -- - - DatelTime <br /> Relinquished by: Received by: <br /> Relinquished by. _ _—_ ___ Received by — <br /> Relinquished by Received by. <br /> NOTE Samples are discarded 60 days after results are reported unless other arrangements are made Hazardous samples m1l be returned to client or disposed of at client expense <br /> Bottle Type L-Liter V-Voa S-Sod Jar O-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br />
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