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ARCHIVED REPORTS_XR0007619
Environmental Health - Public
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EHD Program Facility Records by Street Name
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T
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TRACY
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3775
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3500 - Local Oversight Program
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PR0545738
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ARCHIVED REPORTS_XR0007619
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Entry Properties
Last modified
6/8/2020 12:09:31 PM
Creation date
6/8/2020 12:01:32 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007619
RECORD_ID
PR0545738
PE
3528
FACILITY_ID
FA0003715
FACILITY_NAME
Tracy Blvd Chevron
STREET_NUMBER
3775
Direction
N
STREET_NAME
TRACY
STREET_TYPE
BLVD
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
3775 N TRACY BLVD
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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fax cW of 1-ah Report and COC to Chavron CIP ❑ No5 <br /> Chili —o —C- d — ecof <br /> Chevron Faclilly 1111mbarA-2961i Chevron Canlacl (Name)BRETT HUNTER <br /> Faclluy Address 375 Tract/ Blvd, , Trac, _ (925) 842-8695 <br /> Conudla <br /> C119Vran f'rorlNci� Co, p3US--T3 (Phone <br /> P 0 BOx ON nl t'rolaci (lumbar __ __L F—...- Laboratory tiom■ SEQUOIA <br /> San Ramon, CA 94 3 Consullanl liame BLAINE TECH SERVICES, INC, <br /> 1680 ROGERS AVE. , SAN JOSE labarolory Sertdc■ Order 91!4 4 g <br /> FAX (925)Ag2-8370 Address - Ioboraiory Service Code ZZ02800 <br /> Prolacl Canlacl (llama) CURISTINE 1,11 LIE Samples Collacled by 11 me) 5 Sir''+74\ <br /> 408--573-0555 4013-573-7771 <br /> (Phan■) Vow Number) Signature <br /> State Method ❑ CA ❑ OR ❑ WA ❑ NW Series ❑ CO ❑ UT Remarks <br /> a� <br /> 1 {Q L <br /> '�aJ71 1 <br /> �w�) ✓ �1z W 1��1 �Isl4� d(�� � ?� 4— � Lab Sample No <br /> ►MVV- L 1047 X <br /> f VIAvV-3 - 5 Ito+ <br /> �� <br /> { 0 <br /> COW R-H <br /> B — <br /> ° Rollnqu4 u 11 Sign i f?rgonirallon Date/Tlme �(scalva y (SI9�i1u�e Organlxollan Dala/Tlmy`]3 a (cad Y 11 <br /> f l C C— / Turn Around Time (Circle Chole■) <br /> c/ � <br /> 24 We <br /> Rallnqu s ■d y ignaEu o`-'i/ Organlzalion pale/Tlm■ Received By (Signalura) Organlz Ilan Dale/Time lead Y/!i 49 lira <br /> dpays ---� <br /> Ralingtil Eyed fay (Slgnaiurs) Dr�ga7Imelon Dole/Urna Rarl v d Far (ahorolory By {Signature) <br /> s//DCamonpfr°aycal <br /> adnY�f <br />
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