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ARCHIVED REPORTS_XR0006376
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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PR0528433
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ARCHIVED REPORTS_XR0006376
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Entry Properties
Last modified
4/7/2020 1:11:04 PM
Creation date
4/3/2020 4:47:22 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006376
RECORD_ID
PR0528433
PE
2957
FACILITY_ID
FA0019174
FACILITY_NAME
CHEVRON SERVICE STATION 9-6171
STREET_NUMBER
6633
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
APN
09741048
CURRENT_STATUS
02
SITE_LOCATION
6633 PACIFIC AVE
P_LOCATION
99
P_DISTRICT
002
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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LarvVer Laboratories ForA�ste� orato es use only <br /> WheregA*yisascverxe 1Acct # � Sample# 15 —W SCR# <br /> Q� 4 Analyses Requested <br /> Facility#_2-6171.. . Job#385121 Global IN 70607700035 Matrix Preservation Codes Preservative Codes <br /> SiteAddress 6633 Pacific Ave. , Stockton, CA H=HCI T= NaOH 3 N=HNO3 B=NaOH <br /> Chevron PM Bob Cochran Lead Consultant Secor V S=H2SO4 0=Other <br /> Consultant/OfficeG-R Inc._ 6747 Sierra Ct, Dublin, GA 94568 � c c c N ❑Jvaluereporfingneeded <br /> Z a t3 do ❑Must meet lowest detection limits <br /> ConsultantPq Mgr _Deanna L. Harding _Deanna@grinc.com a. z U ©p03 ossible for 8260 compounds <br /> Consultant Phone# 925-551-7555 Fax# 925-551-7899 0 �+ 8021 MTBE Confirmation <br /> cmo <br /> Sampler Frank 7errinoni m p .0 W $Confirm highest hit by 8260 <br /> E ❑ E3Confirm all hits by 8260 <br /> ❑Non SAR CL a Z <br /> Service Order# o R [1 Run_oxy s on highest hit <br /> Date Time E o o c"o �_ o r d [3 Run_oxy s on all hits <br /> Sample Identification Collected Collected (7 ) m 0 a— m <br /> A"t+'ft X I I I I Comments/Remarks <br /> Pka" &mw al f <br /> CSOG• SO.ApIG <br /> �,tJt�t to6tec <br /> 44-00Z no tq- <br /> Relinquished by r. Date Time Received by ke <br /> Time <br /> Tu nd Time Requested(TAT)(please anile) �1L <br /> D <br /> ;D___TAT 72 hour 48 hour Relinqui tied by at Time Racenr Time <br /> our 4 day 5 day 1 l) ! <br /> Data Package Options(please circle if required) Re q rsh by 1630 <br /> D Time Re ed b Date Time <br /> © �{ <br /> i QC Summary Type I--Full <br /> Type VI(Raw Data) [3Coeit Deliverable not needed linquished by Commercr Ca r Receiv by Date Time <br /> WiP(RWQCB) UPS FedEx ther <br /> alk Temperature Upon Receipt '0 C. Custody Seals Into es No <br /> Y <br /> Lancaster Laboratories,Inc,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 3460 Rev 7130101 <br /> Copies White and yellow should accompany samples to Lancaster Laboratories The pink copy should be retained by the client. <br /> t <br />
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