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Environmental Health - Public
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EHD Program Facility Records by Street Name
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2900 - Site Mitigation Program
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PR0517529
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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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LSauers
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EHD - Public
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Chevron 1 • • W-jon AnalysisRequestlChainof • • <br /> AINncaster Laboratories ( For Lancaster La ratorie a only <br /> I Mee gUalityis a science Acct.#: s t � Sample#: �� 111)k— �r SCR#: <br /> Analyses Requested <br /> Facility#: N=Mn ab— <br /> Preservation Codes Preservative Codes <br /> 1 II <br /> Site Address: .tiIPSI l�L1/\D ` H=HCI T=ThiosulfateN= HNO3 13 =NaOH <br /> Chevron PM: YJ Lead Consultant: ` <br /> S=H2SO4 O=Other <br /> U <br /> Consultant/Office: l c ❑❑ J value reporting needed <br /> 8 ❑Must meet lowest detection limits <br /> Consultant P1. Mgr.: o` <br /> q g 11 O possible for 8260 compounds <br /> v Fax#:CVI� " gConsultant Phone <br /> ¢ Cl 8021 MTBE Confirmation <br /> Sampler: �� m .o w o o = ^ ❑Confirm highest hit by 8260 <br /> 41 <br /> E m „ ❑ <br /> Service Order#: ❑Non SAR: o z'CL <br /> ?� o ❑Confi m all hits by e2so <br /> Field Repeat Top Time New m o o w $ o A ❑Run_oxy's on highest hit <br /> Point Name M if I D th Y nt II cted Fiel Pt. <br /> U F m m I Run_oxy's on all hits <br /> (7 <br /> fel IS rS� I Comments/Remarks <br /> LO I ( '- <br /> 16, <br /> S $'. <br /> mw -7S <br /> t <br /> S D'. D <br /> — ID-.�o <br /> Relin ed b : Date Time Received by: Date Time <br /> and Time Requested(TAT)(please circle) (Dili <br /> STD.T 72 hour 48 hour Relinq she Date Time Received by: ate Time <br /> 24 our 4 day 5 day <br /> Data Package Options(please circle If required) Relinquished by: Date ime Received by: Date Time <br /> OC Summary Type I—Full <br /> Type VI(Raw Data) ❑Coelt Deliverable not needed Relinquished by Co ercial Carrier: Receiv Date Time <br /> WIP(RWOCB) UPS edEx Other <br /> Disk Temperat Receipt att--P—C. Custody Seals Intact? 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 /> Cooies:White and vellow should accompany samples to Lancaster Laboratories. The pink copy should be retained by the client. <br />
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