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Environmental Health - Public
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EHD Program Facility Records by Street Name
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3725
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2900 - Site Mitigation Program
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PR0537795
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Last modified
5/28/2020 4:31:07 PM
Creation date
5/28/2020 4:28:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0537795
PE
2950
FACILITY_ID
FA0021799
FACILITY_NAME
SHELL GAS STATION/ANABI OIL
STREET_NUMBER
3725
STREET_NAME
TRACY
STREET_TYPE
BLVD
City
TRACY
Zip
95304
APN
21217030
CURRENT_STATUS
01
SITE_LOCATION
3725 TRACY BLVD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
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EHD - Public
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CHAIN OF CUSTODY RECORD <br /> McCampbell Analytical. Inc. <br /> I O1 1534 Willow Pass Rd./Pittsburg.Co.94565-1701 TURNAROUND TIME:RLSH❑ 24 HR❑a811R❑72 HR U S\1"LR DAN' <br /> www.mccompbell.com / moin@mccampbell.com GcuTrnckciEDF[jl PDF❑ EDD❑ \\rilcOn(DW)❑ FQnIS[t <br /> Telephone: (877) 252-9262/Fox: (925) 252-9269 <br /> Effluent Sample Requiring"J"flag❑ UST Clean Up Fund ProjecQ:Claim t <br /> Bill To: Isr[a.tn ES' i��_ Analysis Request <br /> Company: <br /> E-Mail: <br /> Tele: (y T[ $'Tia- Fax: <br /> v <br /> Irroiect 4: T,I°1 8 oU Project Name: A�L,; (-T^c4N - <br /> Project Location: 77La r A Purchase Order# WirofBirict I d r = - t r c J <br /> Sampler Si nature: = z - <br /> AIATRLY METHOD <br /> S:iVIPL[N 11RESERVED = _ _ - _ s <br /> is <br /> ? <br /> 21 <br /> S1l�IPLE 1D LocadontTDmilm, <br /> a <br /> Meld Poin <br /> Name <br /> n d asal <br /> (s_ <br /> 14 <br /> le - - - <br /> -mob w <br /> - I <br /> l <br /> I — <br /> "hbL clients MUST disclose any dangerous themlenls known to he present in their submitted samples in eonecatratirms That may cause immcdiv-harm or serious future heatlliendmigcrmrni n.a te.ult of brio$-. <br /> g]orcd.open air,sample handling by MAI stall.Non•dlselosure htcurs an immediate S250 surcharge and the client is mbjert ht full Inial llabillp Inf hurm suffered. Thank.1011 far your undermanding and far <br /> us to work safeh•. <br /> Relinquished By: Date•. Time: H• a / ICFJt' COBIRI[N IN: <br /> �7. /�_DGOODA <br /> TION <br /> &."LteLf 1- ulo, �-, HEAD SPACE ABBE NT .� Ltff HULD <br /> Relinqu{s ted By: Date: 'rime: Receisrd By: DECHLORINATED IN LAB_ <br /> APPROPRIATE CON7.VNERS <br /> PRESERVED IN LAR <br /> Relinquished By: Date Time: Reccis'svi By: VOAS O&C METALS OTHER HA'J_ARDOUSc <br /> PRESERVATION PH< <br /> Page 2 of 9 <br />
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