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FIELD DOCUMENTS
Environmental Health - Public
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EHD Program Facility Records by Street Name
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W
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4747
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2900 - Site Mitigation Program
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PR0517529
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FIELD DOCUMENTS
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Last modified
6/24/2020 6:14:18 PM
Creation date
6/24/2020 2:08:15 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0517529
PE
2950
FACILITY_ID
FA0013491
FACILITY_NAME
CHEVRON SERVICE STATION #200794
STREET_NUMBER
4747
Direction
N
STREET_NAME
WEST
STREET_TYPE
LN
City
STOCKTON
Zip
95202
APN
10437010
CURRENT_STATUS
01
SITE_LOCATION
4747 N WEST LN
QC Status
Approved
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EHD - Public
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Chevron California Jon AnalysisRequestlChainof ( 1 • <br /> Lancaster LaboratoriesFor Lancaster Laboratorl s use only <br /> lNhere qualrtyis ascience. <br /> Acct.#: 10 Sample#: 311) 1(/? – y SCR#: <br /> Analyses Requested <br /> Facility#: I)— lD <br /> Preservation Codes Preservative Codes <br /> H=HCI T=Thiosulfate <br /> Site Address: ���� �K_ �A 1�i D� / J g N=HNO3 B=NaOH <br /> Chevron PM: �OCa`�IYQY>� Lead Consultant: <br /> S=H2SO4 O=Other <br /> �� , � _� U <br /> Consultant/Office: Y 3:1,� V.gJ S ❑ 0 ❑J value reporting needed <br /> > / m o 8 ❑Must meet lowest detection limits <br /> Consultant Prj. Mgr.:/ 0,/ �t/��2)V a e 1 C� 0 m O possible for 8260 compounds <br /> Consultant Phone#6RU1 9 1 I-bL15b Fax# �I QIP )�(p I� ( �� `o 0 o ❑ 8021 MTBE Confirmation <br /> e o e <br /> Sampler: E m a. <br /> r ❑Confirm highest hit by 8260 <br /> 0 0 ❑ <br /> Service Order#: �+ E ❑Confirm all hits by 8260 <br /> ❑Non SAR: o z t <br /> a + m m ,z 0 ❑Run_oxy's on highest hit <br /> Field Repeat Top Time New o o n _ _ <br /> Po <br /> int Name Matrix Sam I De th Year M nth D Collected Field Pt. U -- m m ❑Run oxy's on all hits <br /> W— bl t7 Comments/Remarks <br /> W Ob <br /> -a <br /> -a ► I '. <br /> 1 ,ID <br /> 46 <br /> m -a <br /> 5 I�'. <br /> 5D I '.WO <br /> w- S5 1411r <br /> wished b Date Time Received by: Date Time <br /> nd Time Requested(TAT)(please circle) 1 1 0 <br /> Its- <br /> STD.T 72 hour 48 hour elfin u' ed by: Date Time Received by: ate Time <br /> 24 hour 4 day 5 day <br /> Data Package Options (please circle If required) Relinquished by: Date Time Received by: Date Time <br /> QC Summary Type I–Full <br /> Type VI(Raw Data) ❑Coelt Deliverable not needed Relinquished b Commercial Carrier: R by: Date Time <br /> WIP(RWQCB) UPS FedEx Other <br /> Disk Temperature Upon Receipt-4'-_-;L—C. Cus y 4eaIs I ct7 Yes No <br /> Lancaster Laboratories, Inc.,2425 New Holland Pike,PO Box 12425,Lancaster,PA 17605-2425 (717)656-2300 3460 Rev. 10/04/01 <br /> Copies:White and yellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />
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