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ARCHIVED REPORTS_XR0011916
Environmental Health - Public
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EHD Program Facility Records by Street Name
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N
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NEWTON
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3931
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2900 - Site Mitigation Program
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PR0540573
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ARCHIVED REPORTS_XR0011916
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Entry Properties
Last modified
4/9/2020 2:38:04 PM
Creation date
4/9/2020 2:21:50 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011916
RECORD_ID
PR0540573
PE
2960
FACILITY_ID
FA0023207
FACILITY_NAME
GILLIES TRUCKING INC
STREET_NUMBER
3931
STREET_NAME
NEWTON
STREET_TYPE
RD
City
STOCKTON
Zip
95205
APN
13207017
CURRENT_STATUS
01
SITE_LOCATION
3931 NEWTON RD
P_LOCATION
01
QC Status
Approved
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SJGOV\sballwahn
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EHD - Public
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Inebea esting Services Dallas 1089 East Colh 3,Rieliardson,Tr 75081 (214)238-5591 CHAIN OF CUSTODY ORD <br /> EW Report to Invoice to ANALYSIS !_ab use only <br /> Company Company .c�.� .�' _ REQUESTED Due Date <br /> Address ^5 - Oq Address <br /> 7.)) Temp of coolers <br /> when received(C°) <br /> .11 <br /> Contact Q,f. C,"-4 c,— Contact _��� Ltr�c„�. t 2 3 4 5 <br /> Phone Phone <br /> Custody Seal N/Y <br /> Fax PO/SO # <br /> Intact N 1 Y <br /> SamSampler's Name S m ler Signature Screened <br /> P P 9 For Radioactivity <br /> V L-I& <br /> Prof No Project Name No/Type of Containers <br /> Matra Date Time 01 <br /> ,D a Identifying Marks of Sample(s) VOA AIL 250 Plo r Lab Sample 1D(Lab Use Only) <br /> P b <br /> W IGM -Z cr <br /> Liz> X ik a l <br /> CA — ;Z> <br /> ! C) oc <br /> Turn around time ❑Priority 1 or Standard ❑Priority 2 or 50% ❑Priority 3 or 100% ❑Priority 4 ERS* *BTEX(60218020) TPH(418 1 or 8015) VOLATILES(624/8240) IGNITABILITY TOTAL LEAD(6010) <br /> Re nq by (Signature) Dae Time ceivad by (SI ature) Date Time Remarks <br /> .. <br /> Relinquished by (Signature) Date Time Re roed by (Signature) Date Time <br /> Relinquished by (Signature) Date Time Received by (Signature) Date Time Client s delivery of sampes constitutes acceptance of lnchcapellTS Dallas terms <br /> and conditions contained in the Price Schedule <br /> Matrix WW Wastewater W Water S Sod SD Solid L Liquid A Air Bag C Charcoal tube SL Sludge O Oil ITS-Dallas cannot accept verbal changes <br /> Container VOA 40 ml:vial AIG Amber 1 Or Glass 1 Liter 250 ml Glass wide mouth P10 Plastic or other Please Fax written changes to <br /> 214-238-5592 <br /> OFFICE USE ONLY <br />
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