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ARCHIVED REPORTS_XR0006915
Environmental Health - Public
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EHD Program Facility Records by Street Name
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P
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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_XR0006915
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Entry Properties
Last modified
4/14/2020 1:49:50 PM
Creation date
4/13/2020 3:51:07 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0006915
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
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SJGOV\sballwahn
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EHD - Public
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• • l <br /> 1 <br /> K KAPREALIAN ENGINEERINGo INC. <br /> CHAIN OF CUSTODY <br /> (SAMPLER I SITE ?LAME & ADDRESS I ANALYSES REQUESTED ! TURN AROUND TIME ! <br /> S�oc ! <br /> G/r�o�4� /Ofitoh I l l I 1 I I { I R ICY I <br /> IWITNESSING AGENCY <br /> I I I ql I I I I I I ! <br /> I I I ! 1 I I No I 1 yr <br /> II I <br /> CtJR LT: MJA�RJ K <br /> SAMPLE OF SAMPLING <br /> ID NO DATE TIME SOIL ItB CCMPICONT LOCATION <br /> 1 W 1o f CS7 <br /> { <br /> Pte. <br /> IMtj I I I I x ! X ! ! � I �t k l x l l 1 I l { I <br /> --�— 01 <br /> I M W I Z I q I ! 1 �( ! x 1 I � I � ti I X I X l I 1 I l I ��. I <br /> 4MW 3 ! K ! = .S I I X l x ! 1 t� l K K I x 1 x l { ! I I l u O15Q �p <br /> I I I l I I I I ! I ! I I I ! I I ! <br /> I <br /> I I I I l I I I I I I ! I I I I I I <br /> I <br /> I I 1 I ! ! { I I I 1 I l I 1 I 1 I <br /> /! The fottowing MUST SE completed b the laboratory accepting samples <br /> IRettrquished try (Signature) I Da a/Time I Received by (Signature) � ��,' l.�I �P Y Y P n9 �"P I <br /> '( 9 Soll f for analysis <br /> ' � 1 Have all 'saiiples received for analysts been stored to ices I <br /> IR (i i h by Sig ture) I D to/Time I Recei (Si Lure) <br /> I 119N 12 Will samples remain refrigerated until analyzed? I <br /> IRelt ed na ure) Date/Time Iv (Signat ( 3 Did arty samples received for an is have head space' <br /> I I r�� E l t, <br /> �" 14 Were samples in appropriate containers and properly packaged + <br /> IRetinquished by (Signature) I Date/Time I Received by (Stgnature) <br /> t <br /> Si9nature Title Datc I <br />
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