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ARCHIVED REPORTS_XR0007705
Environmental Health - Public
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EHD Program Facility Records by Street Name
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W
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WILSON
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1250
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2900 - Site Mitigation Program
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PR0507153
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ARCHIVED REPORTS_XR0007705
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Entry Properties
Last modified
10/8/2020 10:36:41 PM
Creation date
6/23/2020 10:34:21 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0007705
RECORD_ID
PR0507153
PE
2950
FACILITY_ID
FA0007717
FACILITY_NAME
THRIFTY OIL #171
STREET_NUMBER
1250
Direction
N
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205
APN
11731001
CURRENT_STATUS
02
SITE_LOCATION
1250 N WILSON WAY
QC Status
Approved
Scanner
LSauers
Tags
EHD - Public
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. • ASSOCIATED LABORATOR4P <br /> 806 North Batavia ■ Orange, CA 92868 <br /> Chain of Custody Record Phone (714) 771-6900 ■ Fax (714) 538-I209 LM\ <br /> 'Company <br /> � �U A Phon <br /> / f P` F7. 0r A L Jab No Page of <br /> Protect Manager �r-r Fax Analysts Requested Test Instructions&Com <br /> ments <br /> Protect Name LL t Protect# /� �/ C f 0 <br /> Site Name 1/ / <br /> and �/ i✓V f f�Is 6)r <br /> Address f-�C�)7 �) C>F C`.I /5 .� 11 <br /> t � ff ��''(T Container <br /> Sample ID Lab ID Date Time Matrix Number/Size Pres t <br /> Ib � <br /> oL t4 o,! rL-,J'iv� HGL <br /> �; _� �� �,o �C X �out•I D� 0 15104 i�h1 N- <br /> 12 �. �;J <br /> 13 —J—H <br /> 14 <br /> 15 <br /> Sample Receipt-To Be Filled By Laboratory Sample�shed by 1 Rehngwshe y 2 Rehngws 6 3 <br /> ew 1! <br /> Total Number of Containers Properly Cooled Y/N!NA � <br /> tur <br /> Signature Signature Signa <br /> �r Printed Name Printed Name Printed Name 4�4 <br /> Custody Seals Y!N/NA Samples Intact Y/N!NA 1Y1� p CT1f f <br /> Date Time Date Time Date Z,��_ ` Time <br /> Received in Good Condition Y/N Samples Accepted Y IN <<<? ���+!q_>J/ <br /> Received By 1 Received B 2 Received By 3 <br /> Turn Around Time re <br /> Signature Signature Signature <br /> Rll$11 ©Same Day 0 48 hrs Printed <br /> nted Name Printed Na a e. ��J Printed Name <br /> Normal ©24 hrs 0 72 hrs /` <br /> Date Time Dat `l«O Time �`�C^ Date Time <br /> �1 X41 <br /> Distribution White-Laboratory Canary Laboratory Pink Project/Account Manager Goldenrod Sampler/Originator // -�- <br />
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