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Environmental Health - Public
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3500 - Local Oversight Program
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PR0545638
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
5/5/2020 11:44:53 AM
Creation date
5/5/2020 10:57:07 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545638
PE
3528
FACILITY_ID
FA0005998
FACILITY_NAME
UNION OIL SS#2859
STREET_NUMBER
1665
STREET_NAME
PACIFIC
STREET_TYPE
AVE
City
STOCKTON
Zip
95204
APN
13702031
CURRENT_STATUS
02
SITE_LOCATION
1665 PACIFIC AVE
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
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U 819 Striker Ave., Suite 8•Sacramento,CA S. •(916)921-9600 U East 11115 Montgomery,Suite B•Spokane,WA 99206•t.,uj)924.9200 <br /> QNuCAL ' <br /> l7 1900 Bales Ave.,Suite LM•Concord,CA 94520•(5 f 0)686-9600 U 15055 S.W.Sequoia Pkwy,Suite 110•Portland,OR 97222-(503)624-9800 .r. <br /> Company Name: tri'-o(Ja Project Name: R�I Ft AV G 9"(aC rJ <br /> Address: j ��C4 �� S ,l UNOCAL Project Manager: -.1 <br /> City: pry State: � ZipCode: f o Release <br /> #: C C(,t:;t.�( ` )/f <br /> Tefe hone: r/-7 L)� FAX #: Site#: °} <br /> U <br /> Re orf T Yo�,�� Sam fer:\ '0t_ttJ <br /> 1 '� ��'�\��' QC Data: Level D (Stannard) ❑ Level C ❑ Level B ❑ Level A � t <br /> Turnaround ' 5 Work Days ❑ 3 Work Days Q Drinking Water (Analyses Requested <br /> a <br /> Time: ❑ 2 Work Das ❑ 1 Work Day ❑ 2-8 Hours ❑ Waste Water <br /> CODE: ❑ Misc. ❑ Detect. ❑ Evai. 2"Remed. ❑ Demol.❑ Closure O Other <br /> Client Datefrime Matrix Hof Cont. Laboratory f� <br /> Sample I.D. Sampled Desc. Coni. Type Sample it QR ' Comments <br /> 0 <br /> 3. (� . <br /> 4. 3 <br /> _o - <br /> 7- <br /> 6. <br /> 7. <br /> 8. <br /> 9. <br /> 10, y0 <br /> Relinquished By: ������ /� Date:( (�'J.` h Time..) Received B <br /> Dale: Time: <br /> a� <br /> Relinquished By: Date: Time: Received By: Date: Time: r <br /> � f � <br /> Relinquished BY: Date: Time: Received By Lab: Date: (7J 9 Time: -7 <br /> Were Samples Received in Good Condition?❑Yes❑No Samples on Ice? 0 Yes O No. e Metho'a'Ahipment Pa _of <br /> . 9 <br /> To be completed upon receipt of report: <br /> 1) Were the analyses requested on the Chain of Custody reported? 0 Yes❑No If no, what analyses are still needed? <br /> 2) Was the report Issued within the requested turnaround time? ❑Yes❑ No If no, what was the turnaround lime? <br /> Approved by: _ —.---..__Signature: ___--.----.----._---.---..Company: __ _T �_. Date: <br />
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