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Environmental Health - Public
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EHD Program Facility Records by Street Name
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THORNTON
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3500 - Local Oversight Program
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PR0545727
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SITE INFORMATION AND CORRESPONDENCE
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Last modified
6/3/2020 4:31:36 PM
Creation date
6/3/2020 4:01:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0545727
PE
3528
FACILITY_ID
FA0005693
FACILITY_NAME
7-ELEVEN INC. STORE #20680
STREET_NUMBER
9110
STREET_NAME
THORNTON
STREET_TYPE
Rd
City
Stockton
Zip
95209
CURRENT_STATUS
02
SITE_LOCATION
9110 Thornton Rd
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
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EHD - Public
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4080 PIKE LANE, SITE c <br /> NGTEL <br /> CHAIN-OF-CUSTODY RECDRD <br /> 510 685-77852 9452a AND ANALYSIS REQUEST 37120 <br /> "'°'"•"�+�"� 1800 423-7143 <br /> Company Name: 9/G ��--1�7 <br /> a�CPhone q: • 1 I ` <br /> -- r c7o <br /> CrV14 WJ1-,' � `,�- ' o FAX #: / -772 r 6`7i�� ❑ <br /> Coe any Ad yrewss•: site Locations y�, G <br /> C <br /> C{' G9 m 1.1 nna iN Q <br /> Pro jeManager:ct : (U a ❑� <br /> ❑4r <br /> Client Project 0 $ 1.1 <br /> ` 01070 0/ ,� ly ❑ O m N sn N m a ra- ^� <br /> 'C-Al4to m m = v <br /> I attest that the proper held sampling Sampler Name(Print): D in m I.I Ll I r} I > i:1 F1 sr <br /> Procedures were used during the a ,� o v L) Cl <br /> collection of Ihese sam les. B�l�G�_. �_ o _ C] g a Io Nt a N !l a1 `] <br /> Matrix Method aD Ico <br /> J <br /> Sampling � <br /> fCl nField GTE_ (1 [.1 z ur <br /> Lab <br /> ❑v* 3d pcn ¢a <br /> a a ID IF aa C4ID Lab Use) W ¢ El roago a o X <br /> w only aa U z a a 4 �o a O x x awwaaT w? O a O P L <br /> W v <br /> yr <br /> p <br /> , <br /> T[Y D Z <br /> o)ry <br /> HTF <br /> .7 --1 r�77,1 <br /> i <br /> TAT Special Handling SPECIAL DETECTION LIMITS REMARKS: <br /> Priority 124 hr) L1 GTEL Contact <br /> Expedited(48 trr) C] Cluole/Contract M <br /> 7 Business� Day� - - <br /> Olher Confirmation N tQC�I.— <br /> Business Days I] P.O.I SPECIAL REPORTING REQUIREMENTS Lab Use Only Lot k: Storage Locallon <br /> QA/QC Levet <br /> + C— <br /> Btue❑ CLP[7 Other❑ FAX[] Work Order l✓: C—s O�? OOSG <br /> Relinquished by Sampler: D le Iq <br /> Tim Received by: <br /> CUSTODY <br /> RECORD Relinquished by; - Time Received by: <br /> 779 <br /> e 95 2 3 <br /> Relinquished by:A�L W a Time Receive by Laboratory: <br /> l `t Z.J� Waybill q (r, <br /> i <br />
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