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ARCHIVED REPORTS_XR0006912
Environmental Health - Public
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EHD Program Facility Records by Street Name
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PACIFIC
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5606
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2900 - Site Mitigation Program
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PR0541401
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ARCHIVED REPORTS_XR0006912
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Entry Properties
Last modified
4/14/2020 1:45:56 PM
Creation date
4/13/2020 3:50:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006912
RECORD_ID
PR0541401
PE
2950
FACILITY_ID
FA0006046
FACILITY_NAME
UNION OIL STATION #5098
STREET_NUMBER
5606
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95207
CURRENT_STATUS
02
SITE_LOCATION
5606 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
SJGOV\sballwahn
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EHD - Public
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i <br /> KAPREALIAN ENGINEERING <br /> I N C 0 A P 0 H A T E O <br /> CHAIN OF CUSTODY <br /> SAMPLER �S T�E V,i_ SITE NAME It ADDRESS ANALYSES REQUESIED TURN AROUND TIME <br /> F°RM�R u1110&4�1# 5-o9$ 5T00-, %/7 - /?_,G_C_�4R - <br /> UI1NESSING AGENCY <br /> 15 6 a 6 Pig-C If CNO <br /> x <br /> SAMPLE OF SAMPLING R E M A R K S <br /> ID NO DATE TIME SOIL WATER GRAB COMP CONT LOCATION <br /> Mw 10 ��a���' y °��'"' X / �f /L't Ct-) X X � <br /> MW Il 6- 05'p M )( x X X ( (-7 5 ose'- x x 4 x X OD At, <br /> r 3 0o pmt u x x x <br /> Re[inquished by (Signature) Date/Time Aecetve by (S) atur the fallowing MUST BE completed by the laboratory accepting samples <br /> 5 f e-i/5 } 2 o C for analysis <br /> Have all samples re�eiv�d for analysis been stored in ice? <br /> Relinquished by Signature) Date/Time Retetved by (Signature) V <br /> 2 Will samples remain ref"-berated until analyzed? <br /> Relinquished by- (Signature) Date/Time Received by (Signature) 3 Did any samples received for analysis have head space? <br /> 4 Were samples i ropriate containers and properly packaged? <br /> Relinquished by (Signature) Date/Time Received by (Signature) <br /> gnature Vate <br /> 2401 Stanwell Unve,Suite 400 <br /> f-Axicurd,California 94520 <br /> TO 51000251(X) 1 ax 5111687 0Ci02 <br />
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