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ARCHIVED REPORTS_XR0011999
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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130
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3500 - Local Oversight Program
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PR0545892
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ARCHIVED REPORTS_XR0011999
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Entry Properties
Last modified
7/22/2020 2:50:08 PM
Creation date
7/22/2020 2:38:56 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0011999
RECORD_ID
PR0545892
PE
3528
FACILITY_ID
FA0003601
FACILITY_NAME
ARCO STATION #826951*
STREET_NUMBER
130
Direction
S
STREET_NAME
WILSON
STREET_TYPE
WAY
City
STOCKTON
Zip
95205-5561
APN
15502064
CURRENT_STATUS
02
SITE_LOCATION
130 S WILSON WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
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LSauers
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EHD - Public
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D- of <br /> Chain of Cusilody ecord On-site Time: Temp: <br /> Project NameOff-site Time: Temp- <br /> r9f� I Ae it,a <br /> BP BUK'ALE)f COR"Orcfalio. A Prolmwe- Sky Conditions: <br /> Conirnei Niunber: Meteorological Events: <br /> Date: <br /> r <br /> Requested Due Date(mm/dd/yy) Meteorological <br /> Speed:. Direction: <br /> Send To: BPIG0w4 Facility No'.'. swkly Consultant/Contractor:!5-tV^it2 <br /> Lab Name: &-opaba-V IRPIGEM Facility Address: Address: <br /> V&+ <br /> Lab Address: c Site ID No. Vt <br /> Site Lat/Ung: e-mail <br /> California Global W#: Consultant/ContrfietorPr6jectNo.:I/!��ti-k <br /> LablIM: A0#,fL,0.,_0, BP/GFM PM Contact. y Consultant/Contractor Tele/Fax: 0,',71, 7Te0% <br /> J(Fele/Fax. 70 Address: Consultant/Contractor PM: !Owjr <br /> Report Type&QC Level, Mhowd-ift— Invoice to: Consultant/Contractor or P/ Circle 011e) <br /> DP/GEM Account No.; TelpfPav l[BP/GEM Work Release No: <br /> Matrix 9 Requested Analysis <br /> Lab Bottle Order No: <br /> Item Sample Point I,Otffong and <br /> Sample Description Ti Laboratory No. <br /> Tithe 79 Comments <br /> No. 0 00 00 <br /> 0 0 <br /> Cn < <br /> 0 <br /> Cn <br /> X I <br /> 3 <br /> 4 YL <br /> v? )Cf <br /> 6 K. <br /> A.- <br /> 7 <br /> 9 1 0 �C COP <br /> 1-14 <br /> la s <br /> W7 101V,0 P1 14 9'"J_o�f itne <br /> Samplees Natne: i R~ Date Time Ccepted By ApLation Date Repo <br /> Type <br /> LM A <br /> Lab Bottle <br /> .Item <br /> Sampler's Company. /RIO f 1 C 11Cq1i1q16b I <br /> 0- -Mwn - 1 <br /> Shipment Date: - P�,�C 71%3 <br /> S ipment Method: - U-00JA-�,A <br /> L <br /> Shipment Tracking No: <br /> Special Instractions: r <br /> datA rip <br /> Of <br /> �Custody Seals In Place Yes No Temperature Blank Yes No Cooler Temperature on Receipt °F/C. Trip Blank Yes No <br /> LABORATORY BP COC Rev.1 215102 <br />
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