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ARCHIVED REPORTS_XR0012000
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_XR0012000
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Entry Properties
Last modified
7/22/2020 2:48:27 PM
Creation date
7/22/2020 2:39:43 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
3500 - Local Oversight Program
File Section
ARCHIVED REPORTS
FileName_PostFix
XR0012000
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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EHD - Public
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rngc:�u� <br /> ." Chain of Custody ®>�d on-site Time: Temp: <br /> �� v'L g%' Off site Time: Tem <br /> rte, Project Name g p= <br /> BP BU/GEM CO (Portfolio: f Sky Conditions: <br /> BP Laboratory Contract Number: Meteorological Events: <br /> Date:�' i°� Requested Due Date(mm/dd/yy) Wind Speed: Direction: <br /> Send To: P/GEM Facility No.: y go, Consultant/ContraCtor: eoa <br /> Lab Name: .�G V/Ay !4BP/GEM Facility Address. (f/, L613Address: 3$ Q .,,� pi•. ,�fL <br /> Lab Address:114 o in, / Site ID No. <br /> mking- eM Site Lat/Long: - e-mail EDD:G 0w49t` y sIvor <br /> California Global ID t#: ® g$ Consultant/Contractor Project No.: ffl,_ <br /> Lab PM: *re_ was° BP/GEM PM Contact: Consultant/Contractor Tele/Fax: fQr�jN.-lo swe <br /> ;Tele/Fax: Z )IOVSAddress: Consultant/ContractorPM: <br /> Report T & Level: �"'p, if yp Invoice to: Consultant/Contractor or PIGS <br /> p Type QC (Circle one) <br /> BP/GEM Account No.: Tele/Fax: •j,y`-��g g' P/GEM Work Release No: <br /> Lab Bottle Order No: Matrix Preservativen Requested Analysis <br /> ItemSemple Description Time a Laboratory No. o _ Sample Point Lat/I ons and <br /> No. O ff] , 0 co oho ` Comments <br /> zO <br /> 3 <br /> Z <br /> z Gvd Z Kv n � <br /> I t p4yeewny- <br /> I <br /> 6 <br /> j 7 pyi - lla91lGs <br /> 9 tp 1k 17111 <br /> 10 yh`y•/p :� 'Of 1 <br /> Sampler's Name: /.( Reliuq ' ! tliation #D,. ime ccepted By I tion Date ime <br /> Sampler's Company: C cl a3 E <br /> Shipment Date: - �O <br /> Shipment Method: efw <br /> Shipment Tracking No: <br /> Special Instructions: / VLH �� f N .rJ L+ N yL. v, <br /> i <br /> Custody Seals In Place Yes No Temperature Blank Yes No Cooler Temperature on Receipt OF/C. Trip Blank Yes No <br /> LABORATORY BP COC Rev.1 215102 <br /> I <br />
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