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ARCHIVED REPORTS_XR0012889
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_XR0012889
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Entry Properties
Last modified
6/8/2020 12:14:49 PM
Creation date
6/8/2020 12:04:27 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012889
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
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EHD - Public
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❑ Yes <br /> Fax-wpy of Lab Report and COC to Chevron Contact ❑ No Chain-of-Custody-Rec:�rd <br /> Chevron Facility Number 9-8264 Chevron Contact Name) Brett Hunter <br /> Chevron Products Co Facility Address 3775 Tracy Blvd , Tracy (Phone) (925) 842-8695 <br /> P 0 BOX 6004 1 Consultant Project Number 9 q 11 23 _A 3 Laboratory Name Sequoia <br /> San Ramon, CA 94583 Consultant Name Blaine Tech Services, Inc Laboratory Service Order 9144488 <br /> FAX (925)842-8370 Address 1680 Rogers Ave , San.lose Laboratory Service Code ZZ02790 <br /> Project Contact(Name) Scott Boor Samples collected by(Name) <br /> (Phone) 408-573-0555 (Fax) 408-573-7771 Signature <br /> State Method ❑ CA ❑ OR ❑ WA ❑ NW Series ❑ CO ❑ UT <br /> 2 U) Remarks <br /> N 4s 0 w <br /> CC6 Q U N a_ 4 y 0 <br /> a QU 2 Hm ¢ v c m p z Q <br /> U X <br /> E U N + + O �' ro m °' m o- `o a <br /> L W = co m O O N Z <br /> Z o Q a v 4 a> m a� a� v U ❑ x <br /> _ of N CD v A m <br /> 'o n x m + + L. � n � F- U u� <br /> �'� a �{ O X a in N O N N U "b N - Z Q <br /> �y n tl rLl� <br /> m N m LU Cq a D7� tr,o rnd X n0 ON �U �X Q tX o <br /> Z u)� ❑ m m ._. O 'xi � °' o~r] e° <br /> Lab Sample No <br /> 1J(-S7 x, x k <br /> i MtV Z W ins 1'73f �e Ne <br /> � Mw ,� w �Lf IFT3 r wa X k <br /> �_�r 1'r3 r82a �C �t <br /> Y W 0 �,t3 it3v <br /> x <br /> lin sh d By(Frgnature) Organization Datel7ime Rece ed By(Signature) Or am ion Da !Ti 1 <br /> m Iced YM Turn Around Time(Circle One} <br /> S R uishe4 Hrs <br /> q y(Si(sig azure] Organlz ion Dat ime Re ei ed (Sig ature) Organrza ion to m Iced YIN a$Nrs <br /> a <br /> elm uished B Si nature 5 Days <br /> C 4 y( ) Orgamz ion Q e/Ti a Received For Laboratory By(Signature) Date/Trme Iced YIN 30 Days <br /> As Contracted <br />
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